To Study Outcome of Concurrent Chemo-Radiation with Cisplatin in Advanced Case of Oral Malignancy

Cancer is a major cause of death in the world Oral cancer has posed a challenge to us with its incidence as high as around 20 % of total body cancers 7 % of all cancer deaths in males and 4 % in females have been reported to be due to oral malignancy recent meta-analyses indicate that concurrent chemoradiation yields an 8 % absolute increase in overall survival at 5 years compared to radiotherapy alone. The aim is to study the outcome of concurrent chemo-radiation with cisplatin in advanced case of oral malignancy. METHODS Between Nov.2013 and June 2015, 50 patients in good condition ranging between 50 to 100 on karnofsky scale with advanced oral cancer treated with combination of chemotherapy & Radiotherapy. The present study included 50 patients of stage III and stage IV oral cancer 35 were male and 15 were females their age varied between 30 yrs to 80 yrs. General physical examination Systemic examination Local examination Complete blood investigation (Haemogram, RFTs, LFTs) Biopsy from the primary tumour and FNAC from metastatic L. Node. Dental evaluation and chest X-ray and X-ray mandible. CT scan head and neck RESULTS The commonest age group was the 4th, 5th and 6th decade. The average age is 52. The male to female ratio is 2.31. These clearly showed preponderance of male. Tobacco chewing is the most common habit in male patient and Mishri application in female patients. Exophytic lesion were high 34/50 cases and commonest in Tongue 46 %. Most common site is Tongue 46 %. Histopathologicaly well differentiated squamous cell carcinoma is commonest i. e 24 cases (48 %) followed by moderately diff. squamous cell carcinoma. incidence of advanced oral malignancy more in Lower (Poor) socioeconomic class than higher + middle class ie.4.51.72 % cases were having poor oral hygiene. It can be seen in the above table response rate in the case of stage III in 100 % & stage IV 90 %. Well differentiated squamous cell carcinoma shows 100 % response to combined therapy where as poor differentiated shows 100 % of no response. CONCLUSION This study included fifty patients of Stage III and Stage IV oral cavity cancer. Thirty five were male and fifteen were female. Average age of disease was 52 years a commonest decade being the 5th decade. clear male preponderance Poor oral hygiene was observed in 72 % majority of cases from lower socioeconomic class i. e.82 % The most common habit in male is chewing tobacco and in female is tobacco mishri application Most of the cases presented in the study between 3 to 4 months i. e.54 % cases. commonest site of malignancy was tongue followed by buccal mucosa 48 % cases were well-differentiated squamous cell carcinoma.25 of them had complete remission and 21 patients had partial remission.4 patients delivered the no response. In conclusion combination of cisplatin and radiotherapy given as once weekly and RT for 33 Fr 5 times a week found to be effective, economical and was better tolerated by the patients.