A STUDY TO ASSESS VARIOUS CYTOLOGICAL CHANGES FOR PREDICTING RADIOSENSITIVITY OF ORAL SQUAMOUS CELL CARCINOMA BY EXFOLIATIVE CYTOLOGY

The cytological study of smears from the mouth was started in Bombay as cancer of the mouth is a frequent disease in India. As observed by Khanolkar while analysing first 10,000 cases in Tata Memorial Hospital, Bombay. He reported that 36 percent of all cancer patients examined had intra-oral cancer. The patients were detected relatively in late stage of disease; instances of beginning stages of cancer observed outside the specialist’s centres were frequently not recognised. Oral cancer is serious and growing problem in many parts of the globe. More than 90% of oral malignancies in the upper aerodigestive tract are squamous cell carcinomas. The majority of oral cancer have risk factors similar to those occurring in the rest of the head and neck or the upper aerodigestive tract. In high risk countries such as Sri Lanka, India, Pakistan and Bangladesh, oral cancer is the most common cancer in men, and may contribute up to 25% of all new cases of cancer. On a visit to a cancer treatment centre, in any of these high-risk countries in South Asia, one may find that at least up to a quarter of the patients warded are suffering from oral cancer. Radiotherapy is frequently used as a standard treatment for carcinoma of the oral cavity either alone or in combination with surgery. The reaction of tumour tissue, as well as the surrounding oral tissues, to radiotherapy depends on their growth rate and inherent susceptibility to radiation, which often shows a marked inter-individual variability making it difficult to assess and predict the outcome of the treatment for individual patients. This dissertation was undertaken to see whether serial cytological evaluation done before, during and post-radiotherapy, in oral cancer patients of different grades can predict radiosensitivity or not. Attempts were also made to identify residual tumour cells in post-radiotherapy scrape smears.