Demographic Profile of Oral Squamous Cell Carcinoma Patients Treated with Radiation Therapy: A Retrospective Observational Study at a Johannesburg Academic Hospital (2014–2019), South Africa

Background Oral squamous cell carcinoma (OSCC) comprises most oral malignancies worldwide and is closely associated with modifiable risk factors such as tobacco and alcohol use. Late-stage presentation is common and contributes significantly to poor treatment outcomes. This study aimed to delineate demographic, clinicopathological features, and radiation-induced toxicities among OSCC patients treated at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) between 2014 and 2019. Methods A retrospective, cross-sectional review of 119 histologically confirmed OSCC cases was conducted. Data included patient demographics, tumour characteristics, alcohol consumption and smoking, treatment modality, and acute radiation-related toxicities. Descriptive statistics and inferential analyses were performed using SPSS version 24.0. Associations between categorical variables were tested using chi-square and Fisher's exact tests; p-values < 0.05 were considered statistically significant. Results Among 119 patients, 71% were male (n = 84) with a mean age of 59.6 years. Black African patients constituted 67% of the cohort. The tongue (30%) and floor of mouth (25%), others were the most common tumour subsites. Most tumours were moderately differentiated (53%), and over 85% presented with stage III or IV disease. Tobacco use was reported in 94% of males and 66% of females, with alcohol use in 73% and 49%, respectively. A significant association was found between combined substance use and higher-grade tumours (p = 0.04). All patients experienced at least one radiation-induced toxicity, with mucositis (61%) and dermatitis (62%) being most frequent. Toxicities were significantly more prevalent in patients receiving concurrent chemoradiotherapy (p < 0.01). Conclusion The study highlights the predominance of advanced-stage OSCC in older males with high-risk habits and underscores the urgent need for early detection strategies and public health interventions. High toxicity rates necessitate enhanced patient education and supportive care during treatment.