Treatment Strategies for Oral Cavity and Oropharyngeal Squamous Cell Carcinoma: A Systematic Review of Neoadjuvant Chemotherapy and Transoral Robotic Surgery.
R Manthru Naik, Naveen Mynam, Priyanka Barman, E G Srichakra, Parthiban Saket, Tanmay Mandal, Nandisha Thakkar
Abstract
Open AccessOral cavity squamous cell carcinoma (OCSCC) and oropharyngeal squamous cell carcinoma (OPSCC) continue to pose major global health burdens, with conventional treatment modalities frequently associated with considerable morbidity. Emerging strategies such as neoadjuvant chemotherapy (NACT) for OCSCC and transoral robotic surgery (TORS) for OPSCC have been introduced to enhance personalization of care and preserve functional outcomes. This systematic review summarizes current evidence on the efficacy, safety and functional results of these modalities. Following PRISMA guidelines, a comprehensive search of major databases was conducted, and risk of bias was assessed for all eligible studies. The included literature evaluated key oncologic parameters such as overall survival, disease-free survival, recurrence rates and margin status, alongside patient-reported and clinician-reported functional measures including swallowing ability, speech outcomes and quality of life indices such as MD Anderson Dysphagia Inventory scores. Safety outcomes such as treatment-related toxicities, complication rates, and requirements for feeding tubes or tracheostomy were also analyzed. The review provides an integrated appraisal of the clinical utility of NACT in OCSCC and TORS in OPSCC, emphasizing their potential to improve oncologic control while minimizing functional impairment, while also addressing the influence of study quality and methodological limitations on the strength of the available evidence.