Hepatocellular Carcinoma with Vascular and Cardiac Involvement in a Young Patient with Non-Cirrhotic Hepatitis B: A Case Report.

BACKGROUND

Tongue squamous cell carcinoma (TSCC) is the most common type of oral cancer. Effective and patient-centered management is essential to reduce mortality, improve survival, and enhance oral health-related quality of life (OHRQoL).

PURPOSE: To assess OHRQoL and pain levels in TSCC patients across radiotherapy phases and the impact of supportive care on treatment adherence and patient well-being.

CASE REPORT: Four patients presented with painful, non-healing tongue ulcers of 4-8 months' duration and were referred to the Oral Medicine Clinic. All were diagnosed with TSCC and underwent radiotherapy. OHRQoL and pain levels were assessed using the oral health impact profile-14 (OHIP-14) and visual analogue scale (VAS), before, during, after radiotherapy. Common intraoral side effects included oral candidiasis, mucositis, and xerostomia, all of which impacted patients' comfort and adherence to ongoing treatment.

CASE MANAGEMENT: Management of radiotherapy-induced side effects included nystatin oral suspension, 0.025% hyaluronic acid mouthwash, diphenhydramine HCl, and artificial saliva gel. Individualized care plans were developed based on patient feedback and treatment tolerance. All patients demonstrated clinical improvement in oral lesions within 1-7 weeks. OHIP-14 and VAS scores improved before treatment (OHIP-14: 30-44; VAS: 9), during treatment (OHIP-14: 27-36; VAS: 8), and one month afterward (OHIP-14: 10-15; VAS: 1-5).

CONCLUSION

The integration of proactive and personalized supportive oral care during radiotherapy can significantly improve OHRQoL and reduce pain levels, facilitating better treatment adherence and patient satisfaction. These findings support the importance of multidisciplinary collaboration and proactive symptom management in TSCC care.