This protocol applies to patients with buccal mucosa cancer presenting at Stage IVB or with distant metastatic spread (Stage IVC). At these advanced stages, the clinical intent shifts to palliation, with the primary aim of disease control, symptom management, and supportive care rather than cure.
Stage IVB and metastatic (Stage IVC) buccal mucosa cancer are managed with palliative intent. Treatment combines systemic therapy and/or radiotherapy alongside best supportive care, aligned to the patient's functional status and disease burden.
For systemic disease or progressive local disease following radiotherapy, the approach centres on platinum-based or single-agent chemotherapy regimens. Several regimen options are available — the selection depends on the specific clinical picture and patient factors.
Stage IV B/metastatic diseases are treated with intent of palliation with chemotherapy and/or RT along with best supportive care.
Systemic disease or progressive local disease after RT could be treated with chemotherapy with any of the following regimens: Single agent methotrexate, single agent cisplatin, cisplatin plus 5-flurouracil, cisplatin plus paclitaxel, cisplatin plus docetaxel or cisplatin plus cetuximab.
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