Palliative Management of Unresectable Oral Carcinoma in Geriatric patients by Laser Ablation and Radiotherapy

Abstract

INTRODUCTION: Oral carcinoma in Geriatric age group presents a challenge in terms of Morbidity and Mortality. There are challenges in form of Age related illnesses and ability of the oncologist to administer surgery and chemotherapy.

Most patients have a bad prognosis due to above factors. This study was carried out in 10 patients over a 4-year period in patients aged 65 and above.

PATIENTS AND METHODS: Laser ablation was offered as an alternative to patients not fit or willing for a long duration surgery. Diode laser was used under sonography control for the procedure in all patients. Multiple small sessions were used to control the growth of tumor. Post procedure various adjuvant modalities were used depending on patient acceptance which are enumerated in the study.

RESULTS: .All patients had a very good pain relief and freedom from tumor swelling .Most patients had an Overall Survival increase from 8 months to 2 yrs. There was no on table mortality. The overall ablation time was under 1 hour in most patients. Quality Index measurements showed as satisfactory score. The OS was largely dependent on overall health status of the patient and size of tumor.

CONCLUSION: Laser ablation for geriatric patients of oral carcinoma is a viable alternative procedure for palliation and overall survival increase. It gives a better quality of life and it is a safer procedure for palliation than a full scale surgery in Geriatric stage 4 inoperable patients.