Studies on improvement of therapeutic value for oral cancer patients of highly advanced aged

• Published in: Journal of Japan Society for Oral Tumors Vol. 6; no. 2; pp. 86 - 94
• Main Authors: Yanagisawa, Shigetaka, Shimizu, Masatsugu, Matsusima, Rintarou, Ono, Keiichirou, Mizuki, Harumi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Oral Oncology 1994
• Subjects: advanced age; oral cancer; therapy criteria; treatment and complication
• ISSN: 0915-5988; 1884-4995
• DOI: 10.5843/jsot.6.86

As a result of the advancement of medical science and technology, radical operations have made it possible to safely treat patients of an advanced age. On the other hand, we sometimes faced sever post-operative complications involving patients of a significanty advanced aged who had no previous history of such tolerance for problems and revealed no abnormal data upon clinical examination. Among the aged, organ and tissue tolerance decreases and physical age and chronological age is not usually coincident. The subjects included 15 oral cancer patients over 80 years of age. Most cases were diagnosed as squamous cell carcinoma. One case was stage I, stage II, and III had five each, and stage IV had two such cases. Simultaneously-occurring multiple cancers were found in two cases, and heterochronous double cancers were found four cases. The cases accounted for 40% of all cases. Regarding those with serious histories, two patients each suffered from ishemic heart disease, pulmonary fibrosis, cerebrovascular accidents, while five cases suffered from severe hypertension. Only three cases revealed no abnormal ECG findings. Under our criteria for aged oral cancer patients, three cases received radical surgery, eight received radiotherapy with chemotherapy and restricted excision, and four received palliative treatment. The radical operations completely controlled the tumors. Radiotherapy resulted in CR in three cases and PR in five cases. In PR cases, three survived for over one year with cancer, with the one patients surviving for 30 months. It is important to consider the value to the aged of radiotherapy. Palliative therapy alone could not obtain good results. Complications such as myocardial infarction and frequent VPC occurred in the case receiving surgical therapy. Consciousness disturbance occurred in three cases and lung fibrosis was observed in two cases. We conclude that radical operations should be performed when possible even among the aged. On the other hand, it is important to actively administer radiotherapy in combination with chemotherapy and limit surgery to patients who are not well enough to endure a radical operation, in the opinion of QOL.