title: Topical agents for oral cancer chemoprevention: A systematic review of the literature.
abstract: We review the use of topical chemoprevention agents in patients with oral potentially malignant disorders (PMD).
  
  
  
  A systematic review of studies on topical chemoprevention agents for oral PMD from 1946 to November 2016 was conducted using the MEDLINE database, Embase, and Cochrane Library. Data were extracted and analyzed from selected studies including study type, sample size, demographics, treatment length, response rate, follow-up time, adverse effects, and recurrence.
  
  
  
  Of 108 studies, twenty-four, representing 679 cases met the inclusion criteria. The clinical lesions evaluated included oral leukoplakia, erythroplakia (OEL), verrucous hyperplasia (OVH), oral lichen planus, larynx squamous cell carcinoma, and oral squamous cell carcinoma (OSCC). The mean complete response rate for topical retinoid therapy was 32%. The mean complete response rate for 1% bleomycin therapy and 0.5% bleomycin was 40.2% and 25%, respectively. The complete response rate of OVH, OEL, and OSCC to photodynamic therapy ranged from 66.7% to 100%.
  
  
  
  There are a paucity of data examining topical treatment of oral PMDs. However, the use of topical agents among patients with oral lesions may be a viable complement or even alternative to traditional surgery, radiation, or systemic chemotherapy, with the advantage of reducing systemic side effects and sparing important anatomic structures. This study of 679 cases represents the largest pooled sample size to date, and the preliminary studies in this systematic review provide support for further inquiry.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
authors.forename: Lucy
authors.initials: L
authors.lastname: Chau
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
authors.forename: Justin T
authors.initials: JT
authors.lastname: Jabara
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA. Electronic address: wlai@oakland.edu.
authors.forename: Wanda
authors.initials: W
authors.lastname: Lai
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Svider
authors.affiliation: Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA.
authors.forename: Blake M
authors.initials: BM
authors.lastname: Warner
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA.
authors.forename: Ho-Sheng
authors.initials: HS
authors.lastname: Lin
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA.
authors.forename: S Naweed
authors.initials: SN
authors.lastname: Raza
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA; Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA; Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Fribley
mesh_terms: D000256:Adenoviridae; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001761:Bleomycin / Q000008:administration & dosage*; D018890:Chemoprevention; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000517:prevention & control*; D050130:Oncolytic Virotherapy; D010778:Photochemotherapy; D012176:Retinoids / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D012176:Retinoids; D001761:Bleomycin
keywords: Administration, topical; Head and neck neoplasms; Leukoplakia, oral; Level of Evidence: 2a; Mouth neoplasms; Retinoids