Radiotherapy for Carcinoma Buccal Mucosa in a Centenarian Patient: A Case Report on Clinical and Therapeutic Perspective

Oral cavity cancer is a prevalent malignancy in India, often presenting in advanced stages, particularly among younger individuals due to rising tobacco use and limited awareness about early detection. However, geriatric patients, especially centenarians, rarely seek or receive definitive cancer treatment due to comorbidities, poor nutritional status, and social challenges. This case report describes a 102-year-old female with well-differentiated squamous cell carcinoma of the left buccal mucosa treated with curative-intent radiotherapy after initial response to oral metronomic chemotherapy (OMCT). Radiotherapy was delivered using a Volumetric Modulated Arc Therapy (VMAT) technique in phased fractions. The patient showed complete clinical response posttreatment, with no residual disease detected. However, after 17 months of disease-free survival, an in-field recurrence was noted. The patient, now nearly 104 years old, is being managed with rechallenge of OMCT and remains under close observation for potential re-irradiation. This case highlights the feasibility of definitive treatment in centenarian head-and-neck cancer patients with good performance status. It underscores the need for individualized treatment approaches based on functional and nutritional status rather than chronological age alone. Furthermore, it demonstrates the importance of comprehensive geriatric assessment tools in guiding treatment decisions and improving outcomes in elderly oncology patients. This may be one of the first documented cases of successful curative treatment in a centenarian with oral cancer in India, emphasizing the potential for favorable outcomes in this unique patient population.