Subscribe to RSS
DOI: 10.1055/s-0041-1730454
Revisiting the Concept of Non- and Minimally Invasive Interventions in Early Glottic Cancer – Part II: Single Therapy Should be Favored over the Combination of Transoral Laser Microsurgery and Radiotherapy, Regarding the Postinterventional Voice Quality
Funding The authors have no financial interest and have not received any financial support for this article.
Abstract
Introduction Early glottic cancer (EGC) is associated with a high cure rate. Hence, patients and physicians also focus on the impact of the proposed treatment on the speaking function of the preserved larynx.
Objectives The present study assessed the impact of single-modality treatment (transoral laser microsurgery [TLM], or radiotherapy) or combination therapy for EGC on postinterventional voicing and explored factors which might explain the related perceptions.
Methods A total of 108 patients filled in the voice handicap index 10 questionnaire, 1 and 2 years postinterventionally. Non-parametric tests were used for the respective statistical analyses.
Results Sixty-four patients were treated with TLM, 15 with radiotherapy, and 29 with both modalities. Transoral microsurgery and radiotherapy were associated with postinterventional dysphonia, which attenuated between the first and second postintervention year (p = 0.000). No association between sociodemographic parameters and the attenuation of postinterventional dysphonia was identified for either treatment modality. Transoral microsurgery and radiotherapy resulted in comparable postinterventional voicing, in the first (p = 0.940) and second (p = 0.196) postintervention years. The addition of TLM to radiotherapy resulted in worse voice quality in the second, compared with the first postintervention year (p = 0.000), demonstrating a detrimental effect on speech intelligibility in noise (p = 0.000).
Conclusion Single therapy should be favored over the combination of TLM and radiotherapy for EGC in terms of retaining better postinterventional voice quality. Postinterventional dysphonia should be taken into account, during preinterventional counseling, as it may exert leverage on the quality of patients' lives. Patients and physicians should acknowledge the optimal time of voice function return, which seems to be extending up to two years posttreatment.
Ethical Approval
All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments.
The research protocol was submitted and received ethical approval by the Ethics Committee of the University of Athens, prior to commencing data collection. Participants were asked to sign a consent form before being enrolled in the study.
Publication History
Received: 22 January 2020
Accepted: 23 February 2021
Article published online:
13 August 2021
© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Lee SH, Hong KH, Kim JS, Hong YT. Perceptual and Acoustic Outcomes of Early-Stage Glottic Cancer After Laser Surgery or Radiotherapy: A Meta-Analysis. Clin Exp Otorhinolaryngol 2019; 12 (03) 241-248
- 2 Forastiere AA, Ismaila N, Lewin JS. et al. Use of Larynx-Preservation Strategies in the Treatment of Laryngeal Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 2018; 36 (11) 1143-1169
- 3 Starmer HM, Tippett DC, Webster KT. Effects of laryngeal cancer on voice and swallowing. Otolaryngol Clin North Am 2008; 41 (04) 793-818 , vii
- 4 Rosen CA, Lee AS, Osborne J, Zullo T, Murry T. Development and validation of the voice handicap index-10. Laryngoscope 2004; 114 (09) 1549-1556
- 5 Behlau M, Zambon F, Moreti F, Oliveira G, de Barros Couto Jr E. Voice self-assessment protocols: different trends among organic and behavioral dysphonias. J Voice 2017; 31 (01) 112.e13-112.e27
- 6 Helidoni ME, Murry T, Moschandreas J, Lionis C, Printza A, Velegrakis GA. Cross-cultural adaptation and validation of the voice handicap index into Greek. J Voice 2010; 24 (02) 221-227
- 7 Hong YT, Park MJ, Hong KH. Characteristics of speech production in patients with T1 glottic cancer who underwent laser cordectomy or radiotherapy. Logoped Phoniatr Vocol 2018; 43 (03) 120-128
- 8 Lane C, Rigby M, Hart R, Trites J, Levi E, Taylor SM. Longitudinal analysis of Voice Handicap Index in early glottic cancer patients treated with transoral laser microsurgery: age, gender, stage and time dependence. J Laryngol Otol 2019; 133 (04) 318-323
- 9 Guimarães AV, Dedivitis RA, Matos LL, Aires FT, Cernea CR. Comparison between transoral laser surgery and radiotherapy in the treatment of early glottic cancer: A systematic review and meta-analysis. Sci Rep 2018; 8 (01) 11900
- 10 Kachuri L, De P, Ellison LF, Semenciw R. Advisory Committee on Canadian Cancer Statistics. Cancer incidence, mortality and survival trends in Canada, 1970-2007. Chronic Dis Inj Can 2013; 33 (02) 69-80
- 11 Guenel P, Engholm G, Lynge E. Laryngeal cancer in Denmark: a nationwide longitudinal study based on register linkage data. Br J Ind Med 1990; 47 (07) 473-479
- 12 Choi SH, Terrell JE, Fowler KE. et al. Socioeconomic and Other Demographic Disparities Predicting Survival among Head and Neck Cancer Patients. PLoS One 2016; 11 (03) e0149886
- 13 Vlastarakos PV, Gkouvali A, Katsochi D. Attitudes and Parameters Affecting the Behavior Toward Precursor Symptoms of Head and Neck Cancer. Ear Nose Throat J 2019; 98 (06) E58-E63