Evaluation of the role of radiotherapy in the management of carcinoma of the buccal mucosa.

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 II, 41% with Stage III, 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.