Successful Completion of Radical Radiotherapy Alone for Cancer of the Palate in a 101-Year-Old Patient: A Case Report

Here, we present the rare case of an oldest-old patient with cancer of the palate who successfully received radical radiotherapy with a good outcome.A 101-year-old woman with a 12-year history of left mandibular gingival squamous cell carcinoma, which was treated with surgery after intra-arterial chemotherapy, was noted to harbor a shallow ulcerative lesion on the left palate during a dental visit.The lesion did not improve despite denture adjustment and oral care instructions, and she was referred to the oral surgery department one month later.Abrasion brush cytology led to the diagnosis of clinical Stage I squamous cell carcinoma.The patient had congestive heart failure after myocardial infarction and chronic kidney disease, and surgery and chemotherapy were challenging due to her advanced age.The patient was offered the option of follow-up without treatment, but she preferred radiotherapy alone, with the understanding that the treatment would need to be terminated early if she could not tolerate the adverse events.She received intensity-modulated radiotherapy (IMRT), which was delivered to a limited area, including the primary lesion on the palate.During treatment, the patient developed grade 2 mucositis of the palate, requiring acetaminophen for pain control.However, she maintained oral intake and was able to complete radiotherapy, with a total dose of 66 Gy/33 fractions.The patient could continue oral intake at the one-year follow-up evaluation.According to information provided by her family, she died 13 months after completing radiotherapy.The patient was treated with the goal of early treatment completion, but the radiotherapy could be safely administered up to the curative dose.As illustrated in this case, radical radiotherapy alone with a curative dose may be considered a safe and effective option in oldest-old patients with head and neck cancer.