Carcinoma of the buccal mucosa is the commonest intraoral malignancy in south India. This article concerns the results of radiotherapy in cancer of the buccal mucosa. Radiotherapy was used as the first line of management in this series and surgery was reserved for failures even though very few patients opted for salvage surgery. Of the 234 evaluable patients, 42% survived disease-free at the end of 3 years with radiotherapy alone. Eighty-five percent of the patients with Stage I, 63% with Stage 11,4196 with Stage 111, and 15% with Stage IV disease survived disease-free at 3 years. With radium implant and small-volume beam-directed external radiotherapy, the survival rates were similar (62% versus 64%). The results of external radiation in advanced disease were dismal. Persistent disease after radiotherapy was a serious problem in advanced stages, especially in view of nonacceptance of salvage surgery by a significant proportion of patients. The most effective way of improving cure rates in cancer of the buccal mucosa seems to be early detection.
Cuneer 61:1326-1331, 1988.
ARCINOMA of the buccal mucosa is the commonest C intraoral malignancy in south India.'.' In this hospital, the Regional Cancer Center, Trivandrum, India, it accounts for 10% of all new cancer cases. It is the commonest cancer in men and third commonest cancer in women. Ninety eight percent of these patients chew natively processed tobacco leaves or tobacco stem along with betel leaves (piper betel), arecanut (Areca catechu), and shell lime. Our hospital policy is to use radiotherapy as the first line of treatment in buccal mucosal cancer. Surgery is reserved as salvage for radiotherapy failures. But surgery was accepted as salvage only by very few patients for fear of deformity and consequent social problems. In a large number of patients, extensive soft tissue and bone involvement makes primary surgical treatment elaborate and mutilating. Primary surgical treatment was never offered in T1 and T2 buccal mucosal cancer in this center.