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Franz L, Pessot N, Gallo C, Tundo I, Spinato G, Marioni G, de Filippis C. Spectro-acoustic voice parameters in transoral laser microsurgery vs exclusive radiotherapy for early-stage glottic carcinoma: A systematic review and meta-analysis. Am J Otolaryngol 2024; 45:104272. [PMID: 38579506 DOI: 10.1016/j.amjoto.2024.104272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024]
Abstract
PURPOSE In early glottic squamous cell carcinoma, similar results have been described in terms of disease control between transoral laser microsurgery (TLM) and radiation therapy (RT). During the past two decades, several studies compared subjective vocal outcomes of exclusive RT with those of TLM, showing a trend towards improving results for TLM over time. However, the objective differences in terms of spectro-acoustic voice parameters between exclusive RT and TLM have been less frequently investigated. The aim of this systematic review with meta-analysis was to evaluate voice quality after TLM and RT treatment for early glottic carcinoma, based on acoustic analysis parameters including jitter, shimmer, noise to harmonic ratio, fundamental frequency and maximum phonation time. MATERIAL AND METHODS A search of the English published literature was conducted on the Pubmed, Scopus and Cochrane databases following PRISMA guidelines. RESULTS A total of 441 titles were retrieved from the search. After full-text screening and application of inclusion/exclusion criteria, 12 articles were included. We found no significant differences between TLM and RT treatment in the considered acoustic analysis parameters, except for Shimmer, with more favorable values reported in the RT group. CONCLUSIONS Considering the spread of the disease and expecting an improvement in long-term survival over time, well-designed and multicentric studies involving larger populations with a long-term follow up are mandatory to better assess objective voice outcomes in terms of spectro-acoustic voice parameters.
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Affiliation(s)
- Leonardo Franz
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Nicholas Pessot
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Chiara Gallo
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Isabella Tundo
- ENT Section, Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Giacomo Spinato
- Section of Otolaryngology, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy.
| | - Cosimo de Filippis
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
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Zhang ZM, Zhao Z, Chen ZX. Impact of Laryngocarcinoma at Different Sites in 16,255 Individuals. EAR, NOSE & THROAT JOURNAL 2024; 103:NP207-NP218. [PMID: 34379550 DOI: 10.1177/01455613211036771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Laryngocarcinoma (LC) is a common malignant tumor of the head and neck, accounting for 1% to 5% of human tumors. The primary objective of the present study was to evaluate the survival time of patients with LC at different sites. METHODS Information concerning patients with LC was extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2016. RESULTS In total, 16 255 patients with LC were selected from the SEER database. Among all patients, 80.2% were male; males also predominated in each tumor site subgroup. Most of the patients were aged between 60 and 69 years, had white ethnicity, were single, and had American Joint Committee on Cancer (AJCC) stage I cancer with T1, N0, and M0. The present study investigated the role of interventions in all LCs at different AJCC stages. Across the whole population, regardless of the intervention used, survival increased in patients at any cancer site. CONCLUSIONS The study found that male sex, age ≥80 years, black ethnicity, single status, T4, N4, M1, and AJCC stage IV were associated with higher mortality rates at all sites of LC. Aggressive interventions, especially surgery and radiotherapy, may improve survival in patients with LC at different sites and with different AJCC stages.
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Affiliation(s)
- Zhi-Min Zhang
- Department of Otolaryngology, Hubei NO.3 People's Hospital of Jianghan University, Wuhan 430033, Hubei, China
| | - Zhang Zhao
- Department of Otolaryngology, Hubei NO.3 People's Hospital of Jianghan University, Wuhan 430033, Hubei, China
| | - Zhu-Xiang Chen
- Department of Otolaryngology, Hubei NO.3 People's Hospital of Jianghan University, Wuhan 430033, Hubei, China
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Dadhich S, Shakrawal N, Soni K, Pareek P, Patro SK. Impact of Radiotherapy on Quality of Life in T2 and Early T3 Laryngeal Carcinoma. Indian J Otolaryngol Head Neck Surg 2023; 75:654-660. [PMID: 37275001 PMCID: PMC10235007 DOI: 10.1007/s12070-022-03397-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 12/07/2022] [Indexed: 12/30/2022] Open
Abstract
Objective- To acknowledge patient-perceived voice-related and overall quality of life (QOL) in addition to disability index based on the validated voice-related quality of life survey (VRQOL), WHOQOL-BREF, and WHO DAS II questionnaires in T2 and early T3 laryngeal tumors after definitive radiotherapy. Methods- 35 patients of T2(15) and early T3(20) tumors were enrolled, assessed with three questionnaires of VRQOL, WHOQOL-BREF, and WHO DAS II before the start of radiotherapy, then at 12 and 24 weeks after radiotherapy, and the results were analyzed. Results- All 35 (100%) patients had significant vocal deterioration with a raw VRQOL score of more than 25 at the beginning, which significantly improved at 12 weeks post-radiotherapy (p < 0.5). However, VRQOL scores at the 12th and 24th weeks were statistically insignificant. On comparing the WHOQOL-BREF and WHO DAS II, domains of physical health, psychological health, and participation in society showed significant improvement in both the groups after radiotherapy except distress scores in T2 laryngeal cancers, where pre and post-radiotherapy scores were not significantly different suggesting residual distress. Conclusion- The QOL parameters improve significantly with treatment, however, there exists a persistence of residual distress even at 24 weeks after radiotherapy and hence, routine involvement of clinical psychologists should be emphasized in practice to alleviate anxiety, distress, and concerns regarding disease outcome and recurrence. 12 to 24 weeks post-radiotherapy can be an optimum time to gauge the improvement in the patient-related QOL outcome parameters and does not differ much between these durations. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03397-3.
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Affiliation(s)
- Saket Dadhich
- Department of Otorhinolaryngology, AIIMS, Jodhpur, India
| | - Neha Shakrawal
- Department of Otorhinolaryngology, AIIMS, Jodhpur, India
- Department of Otorhinolaryngology & Head-Neck Surgery, AIIMS, Delhi, India
- Department of Otorhinolaryngology & Head-Neck Surgery, PGIMER, Chandigarh, India
| | - Kapil Soni
- Department of Otorhinolaryngology, AIIMS, Jodhpur, India
| | - Puneet Pareek
- Department of Otorhinolaryngology , AIIMS, Jodhpur, India
| | - Sourabha K Patro
- Department of Otorhinolaryngology, AIIMS, Jodhpur, India
- Department of Radiation Oncology, AIIMS Jodhpur, Jodhpur, India
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4
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Yılmaz T. Voice After Cordectomy Type I or Type II or Radiation Therapy for Large T 1a Glottic Cancer. Otolaryngol Head Neck Surg 2023; 168:798-804. [PMID: 35943800 DOI: 10.1177/01945998221117453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE T1a glottic cancer can be treated with transoral laser microsurgery (TLM) or radiation therapy (RT). Dysphonia is the major disadvantage of TLM, and preservation of voice appears to be the best advantage of RT compared to TLM. Studies on voice outcomes of both options gave conflicting results, but there is a tendency toward better voice outcome after TLM compared to the past. STUDY DESIGN Nonrandomized retrospective cohort study. SETTING Tertiary referral center. METHODS In total, 172 patients with a cancer lesion involving more than two-thirds of 1 membranous vocal fold underwent cordectomy type I (n = 56) (C1 group) or type II (n = 59) (C2 group) or RT (n = 57) (RT group). GRBASI (grade, roughness, breathiness, asthenia, strain, instability), videolaryngostroboscopy, Voice Handicap Index-30, acoustic analysis including F0, jitter, shimmer, noise to harmonic ratio, cepstral peak prominence, and cepstral spectral index of dysphonia using running speech, and aerodynamic analysis were performed before treatment and 6 and 24 months after treatment. RESULTS Study groups did not differ significantly on pretreatment voice outcomes (P > .05). The RT group had significantly better voice outcomes at 6 months posttreatment compared to the C1 and C2 groups (P < .05). The C1 group had significantly better voice outcomes at 6 months posttreatment compared to the C2 group (P < .05). The C1 group had significantly better voice outcomes at 24 months posttreatment compared to the RT and C2 groups (P < .05). The RT and C2 groups did not differ significantly at 24 months posttreatment (P > .05). CONCLUSION Voice outcomes after C2 are equal to RT. C1 has better voice outcomes than RT. C1 and C2 can be the treatment of choice for large T1a glottic cancers.
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Affiliation(s)
- Taner Yılmaz
- Hacettepe University Faculty of Medicine, Department of Otolaryngology-Head & Neck Surgery, Ankara, Turkey
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Long-term functional outcomes in tumour stage T 2 glottic carcinoma after radiotherapy. J Laryngol Otol 2022:1-6. [PMID: 35871793 DOI: 10.1017/s0022215122001682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To evaluate the long-term functional outcomes in patients who received primary radiotherapy for tumour-node stage T2N0 glottic carcinoma, stratified for tumour extension. METHODS A cross-sectional study was performed on patients who were treated with radiotherapy for T2N0 glottic carcinoma. Four questionnaires were used to measure different aspects of functional outcome. In addition, objective evaluation and perceptual analysis were performed. RESULTS Fourteen patients were included in this study. The median time between the start of radiotherapy and assessment was 42 months (range, 26-143 months). Patients reported high-level functioning, with low symptom scores and good swallowing function, and showed a median dysphonia grade of 1.5. The median Voice Handicap Index-30 score was 17.5. CONCLUSION Patients with T2N0 glottic carcinoma treated with radiotherapy had good long-term quality of life, with low symptom scores, good swallowing functioning and slightly elevated voice outcome parameters.
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Álvarez-Marcos C, Vicente-Benito A, Gayol-Fernández Á, Pedregal-Mallo D, Sirgo-Rodríguez P, Santamarina-Rabanal L, Llorente JL, López F, Rodrigo JP. Voice outcomes in patients with advanced laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy. ACTA OTORHINOLARYNGOLOGICA ITALICA 2022; 42:243-249. [PMID: 35880365 PMCID: PMC9330749 DOI: 10.14639/0392-100x-n1992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/14/2022] [Indexed: 11/23/2022]
Abstract
Objective Patients with locally advanced laryngeal and hypopharyngeal cancer (LHC) are often treated with chemo-radiotherapy to avoid total laryngectomy, although voice problems may occur even if not markedly manifest. We sought to evaluate the impact of chemoradiation on voice and quality of life. Methods We studied 21 patients with locally advanced LHC with tumour control at least two years after chemo-radiotherapy. None manifested clinical symptoms related to the treatment and maintained an activity considered as within normal limits. All patients had a voice handicap index (VHI) of less than 15. Voice function was evaluated by perceptual vocal analysis (CAPE-V) and aerodynamic and acoustic study. Quality of life was assessed with the EORTC-H&N35 (voice items 46, 53 and 54). Results Voice changes were frequent, with alterations in all CAPE-V attributes, and predominantly type II and III spectrograms in acoustic analysis (78%). The EORTC-H&N35 scale showed a reduction in scores in 10-40% of items related to voice. Conclusions Subclinical voice disorders are common after chemo-radiotherapy. Although patients consider vocal impairment to be very minor and to not interfere with their daily life, it may contribute to a reduced quality of life.
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Gupta A, Wong KH, Newbold K, Bhide S, Nutting C, Harrington KJ. Early-Stage Glottic Squamous Cell Carcinoma in the Era of Image-Guided Radiotherapy. Front Oncol 2021; 11:753908. [PMID: 34616688 PMCID: PMC8488425 DOI: 10.3389/fonc.2021.753908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Early-stage squamous cell cancer (SCC) of the glottis has a good prognosis. Therefore, patients have long survival outcomes and may potentially suffer from late toxicities of radiotherapy. Radiotherapy with a conventional parallel-opposed-pair or anterior-oblique beam arrangements for stage 1 and 2 glottic SCC have field borders that traditionally cover the entire larynx, exposing organs-at-risk (e.g. carotid arteries, contralateral vocal cord, contralateral arytenoid and inferior pharyngeal constrictor muscles) to high radiation doses. The potential long-term risk of cerebrovascular events has attracted much attention to the dose that carotid arteries receive. Swallow and respiratory motion of laryngeal structures has been an important factor that previously limited reduction of the radiation treatment volume. Motion has been evaluated using multiple imaging modalities and this information has been used to calculate PTV margins for generation of more limited target volumes. This review discusses the current literature surrounding dose-effect relationships for various organs-at-risk and the late toxicities that are associated with them. This article also reviews the currently available data and effects of laryngeal motions on dosimetry to the primary target. We also review the current limitations and benefits of a more targeted approach of radiotherapy for early-stage glottic SCCs and the evolution of CT-based IGRT and MR-guided radiotherapy techniques that may facilitate a shift away from a conventional 3D-conformal radiotherapy approach.
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Affiliation(s)
- Amit Gupta
- Radiotherapy and Imaging, The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, United Kingdom
| | - Kee Howe Wong
- Head and Neck Department, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Kate Newbold
- Head and Neck Department, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Shreerang Bhide
- Radiotherapy and Imaging, The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, United Kingdom
| | - Chris Nutting
- Radiotherapy and Imaging, The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, United Kingdom
| | - Kevin Joseph Harrington
- Radiotherapy and Imaging, The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, United Kingdom
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Krishtopova MA, Semenov SA, Petrova LG. [Linguistic adaptation and validation of the voice handicap index (VHI)-30 in patients with dysphonia into Russian]. Vestn Otorinolaringol 2021; 86:20-27. [PMID: 34269019 DOI: 10.17116/otorino20218603120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose of the study is to assess the internal consistency, reliability of retesting and clinical reliability of the Russian version of the Voice Handicap Index (VHI)-30 questionnaire. MATERIAL AND METHODS It is prospective observational study. The original English version of the VHI-30 questionnaire was translated into Russian by two independent researchers (professional translators). The final Russian version (VHI-30rus) was formulated by a third researcher (otorhinolaryngologist) on the basis of these two translations, and then translated back into English. The 181 participants were included in this study. The main group patients (n=91) were additionally divided into subgroups in accordance with the form of dysphonia: 65 (71.4%) patients had functional and organic dysphonia, 8 (8.8%) had chronic inflammatory diseases of the larynx, 7 (7.7%) - benign neoplasms of the larynx (singing nodules, polyps, cysts), 11 (12.1%) - unilateral laryngeal paralysis. The control group consisted of 90 people without voice disorders. Internal consistency (Cronbach's α coefficient), retest reliability (intraclass correlation coefficient (ICC) VHI-30, comparison of VHI-30 indicators of patients and studied control group (Mann-Whitney U-test, Kruskal-Wallis test) and correlation with the overall severity of dysphonia (Spearman's ρ rank correlation coefficient) were determined. RESULTS In the patient group, we observed excellent internal consistency for VHI-30rus (α=0.95) and good internal consistency for all VHI-30rus subscales: physical (α=0.88), functional (α=0.88), and emotional (α=0.88). The intraclass correlation coefficient (ICC) indicated high retest reliability for patients (0.99) and control group subjects (0.84). The 30-item mean total values for patients with dysphonia were statistically significantly higher than for control group participants (p<0.001). A correlation was found between the overall VHI-30rus value and the overall severity of dysphonia (ρ=0.748, p<0.001). In the patient's group, female and male participants showed a statistically insignificant difference in the total value of VHI-30rus (Mann-Whitney U-test, p<0.001). There was a correlation in terms of VHI-30rus indicators in different subgroups of the patient group and the control group (Spearman's correlation coefficient: functional dysphonia - 0.942; chronic laryngitis - 0.756; unilateral laryngeal paralysis - 0.888; benign neoplasms - 0.982; control group studied - 0.882). CONCLUSION As a result of this study, the VHI-30 questionnaire was translated from English into Russian for use in the Russian-speaking environment. The study showed good internal consistency, retest reliability, and clinical validity for the Russian version of the VHI-30rus questionnaire. The VHI-30rus questionnaire can be recommended for use in clinical practice for patients with dysphonia.
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Affiliation(s)
- M A Krishtopova
- Vitebsk State Order of Friendship of Peoples Medical University, Vitebsk, Republic of Belarus
| | - S A Semenov
- Vitebsk City Clinical Emergency Hospital, Vitebsk, Republic of Belarus
| | - L G Petrova
- Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus
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Asymptomatic swallowing disorders may be present in individuals with laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy. Eur Arch Otorhinolaryngol 2021; 279:995-1001. [PMID: 33963434 DOI: 10.1007/s00405-021-06861-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Patients with advanced laryngeal and hypopharyngeal cancer are often treated with chemo-radiotherapy to avoid total laryngectomy. Subclinical swallowing disorders could be present in these patients even though patients do not complain of any symptoms. We sought to evaluate the impact of chemoradiation on swallowing and quality of life. METHODS We studied 21 patients undergoing chemo-radiotherapy for advanced laryngeal and hypopharyngeal cancer. All patients were tumor-free and none reported symptoms related to dysphagia during follow-up or showed altered routine screening tests (EAT-10) to detect it. Swallowing functions were assessed using volume-viscosity swallow test (V-VST) and fiberoptic endoscopic evaluation of swallowing (FEES). Quality of life was assessed with the EORT-H&N35, and SWAL-QOL scales. RESULTS Frequent alterations in swallowing efficacy (100%) and safety (85.5%) were detected with V-VST and FEES. Quality-of-life scales showed a reduction in their scores between 12 and 17%, mainly in the areas of symptoms. CONCLUSION Swallowing disorders are common after chemo-radiotherapy, even in patients who do not clinically manifest these disorders, contributing to a decrease in patients' quality of life. FEES and V-VST are useful procedures to detect asymptomatic swallowing disorders.
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Staníková L, Zeleník K, Formánek M, Seko J, Walderová R, Kántor P, Komínek P. Evolution of voice after transoral laser cordectomy for precancerous lesions and early glottic cancer. Eur Arch Otorhinolaryngol 2021; 278:2899-2906. [PMID: 33738567 PMCID: PMC8266776 DOI: 10.1007/s00405-021-06751-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/11/2021] [Indexed: 11/18/2022]
Abstract
Purpose To evaluate voice quality evolution after a transoral laser cordectomy (TLC) for precancerous lesions and early glottic cancer. Methods This prospective study enrolled 18 patients scheduled for TLC for high-grade dysplasia, Tis, T1, and T2 glottic squamous cell cancers, from May 2017 to March 2020. Patients were grouped according to the extent of TLC: Group I (n = 11, 61.1%): unilateral subepithelial or subligamental cordectomy; Group II (n = 7, 38.9%): unilateral transmuscular, total, or extended cordectomy. Voice quality parameters, including dysphonia grade (G), roughness (R), breathiness (B), maximal phonation time (MPT), jitter, and shimmer, were evaluated before, and at 6 weeks and 6 months after the TLC. Results In Group I, the degree of G and R items remained without substantial improvement 6 weeks after surgery; however, improved above the pre-surgery level up to 6 months after surgery. The MPT, jitter, and shimmer did not change significantly at 6 weeks or 6 months post-TLC. In Group II, G, R, and B remained significantly impaired even 6 months post-surgery. Jitter, and shimmer worsened at 6 weeks, but reached preoperative levels at 6 months post-surgery. MPT was significantly worse at 6 weeks and remained deteriorated at 6 months post-surgery. All measured parameters were significantly worse in Group II than in Group I at 6 weeks and 6 months post-surgery. No patient required a phonosurgical procedure. Conclusion After a TLC, voice quality evolution depended on the extent of surgery. It did not improve at 6 weeks post-surgery. Improvements in less extent cordectomies occurred between 6 weeks and 6 months post-surgery. Understanding voice development over time is important for counseling patients when considering phonosurgical procedures.
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Affiliation(s)
- Lucia Staníková
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52, Ostrava, Czech Republic
| | - Karol Zeleník
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52, Ostrava, Czech Republic. .,Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
| | - Martin Formánek
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52, Ostrava, Czech Republic.,Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Jana Seko
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52, Ostrava, Czech Republic
| | - Radana Walderová
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52, Ostrava, Czech Republic
| | - Peter Kántor
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52, Ostrava, Czech Republic.,Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Pavel Komínek
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52, Ostrava, Czech Republic.,Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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Du Y, Shao S, Lv M, Zhu Y, Yan L, Qiao T. Radiotherapy Versus Surgery-Which Is Better for Patients With T1-2N0M0 Glottic Laryngeal Squamous Cell Carcinoma? Individualized Survival Prediction Based on Web-Based Nomograms. Front Oncol 2020; 10:1669. [PMID: 33014833 PMCID: PMC7507900 DOI: 10.3389/fonc.2020.01669] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/28/2020] [Indexed: 12/26/2022] Open
Abstract
Background Both radiotherapy and surgery are now recommended for early stage glottic laryngeal squamous cell carcinoma (LSCC), and both have their own advantages in patients with different characteristics. For each patient, it is hard to determine whether radiotherapy or surgery is more appropriate. Methods Patients with T1-2N0M0 glottic LSCC who received radiotherapy or surgery in the 2004–2016 SEER database were reviewed, then randomly divided into training and validation cohorts. Propensity score matching was used to eliminate the baseline variations, and competing risk analyses helped to exclude the effects of other causes of death. Based on univariate and multivariate analyses, we built two nomograms to visually predict the survival of each patient with different characteristics who received radiotherapy or surgery, then validated the accuracy in both training and validation cohorts. Using nomogramEx, we quantified the algorithms of the nomograms and put the nomograms on the websites. Results A total of 6538 patients in the SEER database were included. We found that therapy (p = 0.004), T stage (p < 0.001), age (p < 0.001), race (p < 0.044), grade (p = 0.001), and marital status (p < 0.001) were independent prognostic factors. Two nomograms were built to calculate the survival for each patient who received radiotherapy (C-index = 0.668 ± 0.050 in the training cohort and 0.578 ± 0.028 in the validation cohort) or underwent surgery (C-index = 0.772 ± 0.045 in the training cohort and 0.658 ± 0.090 in the validation cohort). Calibration plots showed the accuracy of the nomograms. Using the nomograms, we found that 3872 patients (59.22%) had no difference between the two therapies, 706 patients (10.80%) who received radiotherapy had better survival outcomes, and 1960 patients (29.98%) who underwent surgery had better survival outcome. Conclusion Nomograms were used to comprehensively calculate independent factors to determine which treatment (radiotherapy or surgery) is better for each patient. A website was used to offer guidance regarding surgery or radiation for patients and physicians.
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Affiliation(s)
- Yajing Du
- Center for Tumor Diagnosis and Therapy, Jinshan Hospital, Fudan University, Shanghai, China
| | - Shali Shao
- Center for Tumor Diagnosis and Therapy, Jinshan Hospital, Fudan University, Shanghai, China
| | - Minghe Lv
- Center for Tumor Diagnosis and Therapy, Jinshan Hospital, Fudan University, Shanghai, China
| | - Yi Zhu
- Department of Radiation Oncology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Li Yan
- Department of Radiation Oncology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Tiankui Qiao
- Center for Tumor Diagnosis and Therapy, Jinshan Hospital, Fudan University, Shanghai, China
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Ferreira N, Netto E, Fonseca L, Fonseca J, Esteves S, Labareda M, Mota A, Pocinho R, Magalhães M, Santos F. Surgery versus radiotherapy: Long term outcomes of T1 glottic cancer. Rep Pract Oncol Radiother 2020; 25:860-866. [PMID: 32982591 DOI: 10.1016/j.rpor.2020.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/05/2020] [Accepted: 08/12/2020] [Indexed: 01/04/2023] Open
Abstract
Aim The aim of this study was to compare the outcomes, patterns of failure and laryngeal preservation rates in patients with T1N0 glottic cancer treated with surgery or radiotherapy. Materials/methods Retrospective study of T1N0 glottic cancer patients treated in our institution between January 2007 and December 2017. Histologically proven squamous cell carcinoma patients, treated with upfront cordectomy/partial laryngectomy (S group) or radiotherapy (RT group) were included. Elective treatment of the neck was not permitted. Local failure (LF), disease-free survival (DFS), ultimate disease-free survival (UDFS), laryngectomy-free survival (LFS), disease-specific mortality (DSM) and overall survival (OS) were evaluated. Results Two hundred and one patients were eligible (172 S group, 29 RT group), with a median follow-up of 38.8 months. Overall, 33 (16%) patients had a recurrence, 30 (17%) in the S group and 3 (10%) in the RT group. Local failure was the predominant site of failure (28 S, 2 RT). Overall, of all those that were salvaged, 17 (8%) underwent total laryngectomy (15 S, 2 RT). There was no significant difference in the 5-year cumulative incidence of LF (20.8% S, 8.1% RT, p = 0.138), 5-y LFS (85.0% vs. 91.7%, p = 0.809), 5-y DFS (67.5% vs. 82.1%, p = 0.343), 5-y UDFS (82.5% vs. 90.3%, p = 0.647) and 5-y OS (84.5% vs. 90.3%, p = 0.892). Multivariate analysis showed no correlation between initial treatment and the analyzed outcomes. Conclusion Primary surgery or radiotherapy were similar first line options, since they do not differ in all outcomes. Patients' and physician's preferences must be considered when choosing first treatment.
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Affiliation(s)
- Nelson Ferreira
- Instituto Português de Oncologia de Lisboa Francisco Gentil - EPE, Radiation Oncology, Lisboa, Portugal
| | - Eduardo Netto
- Instituto Português de Oncologia de Lisboa Francisco Gentil - EPE, Radiation Oncology, Lisboa, Portugal.,NOVA Medical School, Faculdade de Ciências Médicas, Lisboa, Portugal
| | - Leonor Fonseca
- Instituto Português de Oncologia de Lisboa Francisco Gentil - EPE, Radiation Oncology, Lisboa, Portugal
| | - João Fonseca
- Instituto Português de Oncologia de Lisboa Francisco Gentil - EPE, Radiation Oncology, Lisboa, Portugal
| | - Susana Esteves
- Instituto Português de Oncologia de Lisboa Francisco Gentil - EPE, Clinical Research Unit, Lisboa, Portugal
| | - Miguel Labareda
- Instituto Português de Oncologia de Lisboa Francisco Gentil - EPE, Radiation Oncology, Lisboa, Portugal
| | - António Mota
- Instituto Português de Oncologia de Lisboa Francisco Gentil - EPE, Radiation Oncology, Lisboa, Portugal
| | - Rute Pocinho
- Instituto Português de Oncologia de Lisboa Francisco Gentil - EPE, Radiation Oncology, Lisboa, Portugal
| | - Miguel Magalhães
- Instituto Português de Oncologia de Lisboa Francisco Gentil - EPE, Otorhinolaryngology, Lisboa, Portugal
| | - Filomena Santos
- Instituto Português de Oncologia de Lisboa Francisco Gentil - EPE, Radiation Oncology, Lisboa, Portugal
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Wang G, Li G, Wu J, Song P. Analysis of prognostic factors for Tis-2N0M0 early glottic cancer with different treatment methods. Braz J Otorhinolaryngol 2020; 88:375-380. [PMID: 32830100 PMCID: PMC9422441 DOI: 10.1016/j.bjorl.2020.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION In many regions, laryngeal carcinoma is a common upper respiratory tract cancer, most commonly involving the glottic region. The treatment of early glottic cancer includes radiotherapy, open surgery and laryngeal laser microsurgery. However, the preferred treatment for early glottic cancer is still controversial. OBJECTIVES To study the factors affecting the 5-year survival rate of Tis-2N0M0 early glottis cancer and to demonstrate the oncological safety of different treatments. METHODS 144 patients with early glottic cancer were analyzed retrospectively. All patients were clinically node negative. 53 patients underwent open surgery, transoral CO2 laser microsurgery in 46 cases and radiotherapy in 45 cases. The patients were followed up for 26 - 84 months, with an average follow-up period of 62.9 months. RESULTS The 5-year overall survival was 82.6%. The 5 year survival rates of open surgery, laser microsurgery and radiotherapy were 83.0%, 82.6% and 82.2%, respectively. There was no significant difference in 5-year survival rate among the three treatments (p = 0.987). In multivariate analysis, age, T-stage, pathological grading, and anterior commissure involvement were important prognostic factors for early glottic cancer. CONCLUSIONS There was no significant difference in 5 year survival rate among patients treated by either radiotherapy, laser microsurgery or open surgery for early glottic cancer. We urge more attention to the age, T-stage, pathological grade, and anterior commissure involvement of the patients.
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Affiliation(s)
- Guanyu Wang
- Heping Hospital Affiliated to Changzhi Medical College, Department of Radiotherapy, Changzhi, PR China
| | - Guodong Li
- Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Department of Otolaryngology, Taiyuan, PR China
| | - Jianjun Wu
- Heping Hospital Affiliated to Changzhi Medical College, Department of Radiotherapy, Changzhi, PR China
| | - Penghui Song
- Heping Hospital Affiliated to Changzhi Medical College, Department of Radiotherapy, Changzhi, PR China.
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14
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Salas-Salas BG, Domínguez-Nuez DJ, Cabrera R, Ferrera-Alayón L, Lloret M, Lara PC. Hypofractionation vs. conventional radiotherapy fractionation in the conservative treatment of T1 glottic cancer: a prospective cohort study. Clin Transl Oncol 2019; 22:151-157. [DOI: 10.1007/s12094-019-02118-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/12/2019] [Indexed: 10/26/2022]
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15
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Hendriksma M, van Loon Y, Klop WMC, Hakkesteegt MM, Heijnen BJ, El Hasnaoui I, de Jong M, Langeveld TPM, van Benthem PPG, Baatenburg de Jong RJ, Sjögren EV. Quality of life and voice outcome of patients treated with transoral CO 2 laser microsurgery for early glottic carcinoma (T1-T2): a 2-year follow-up study. Eur Arch Otorhinolaryngol 2019; 276:805-814. [PMID: 30810819 PMCID: PMC6411677 DOI: 10.1007/s00405-019-05348-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/13/2019] [Indexed: 02/06/2023]
Abstract
Purpose Longitudinal studies in laryngeal cancer can provide clinicians information about short-term and long-term functional outcomes, like quality of life (QoL) and voice outcome. This information is important when counseling patients or choosing a primary treatment modality. The present study assessed long-term (2 years) QoL and voice outcome in patients with extended T1 and limited T2 glottic carcinoma treated with transoral CO2 laser microsurgery (TLM) (unilateral type III or bilateral type II resections). Methods Three questionnaires were administered: the Voice Handicap Index (VHI), the European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaire (QLQ)-C30, the EORTC QLQ-HN35. A perceptual voice evaluation at six different time points was conducted: preoperatively, and postoperatively at 6 weeks, 3 months, 6 months, 1 year, and 2 years. Fluctuations over time were investigated. Results Sixty-one patients were included in the analysis. Patients reported high-level functioning and low symptom scores 2 years postoperatively. Gender significantly affected the VHI scores at 2 years (mean VHI scores: female 8.7 vs. male, 23.9; p = 0.023). The major improvement in VHI scores was observed within the first 6 months. The tumor stage (T1a, T1b, and T2) significantly impacted the grade (mean scores at 2 years: 1.0, 1.9, and 1.7; p = 0.001). These scores stabilized at 6 months. Conclusions Patients show good long-term QoL with low symptom scores, a low voice handicap, and mild to moderate dysphonia, 2 years postoperatively. Scores stabilize at 6 months and provide a clear indication of status at 1 and 2 years.
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Affiliation(s)
- Martine Hendriksma
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
| | - Yda van Loon
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - W Martin C Klop
- Department of Head and Neck Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Marieke M Hakkesteegt
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Bas J Heijnen
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Ibtissam El Hasnaoui
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Martin de Jong
- Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Ton P M Langeveld
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Paul G van Benthem
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Elisabeth V Sjögren
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
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16
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Watson M, Drosdowsky A, Frowen J, Corry J. Voice Outcomes after Radiotherapy Treatment for Early Glottic Cancer: Long-Term Follow-Up. J Voice 2018; 32:636-642. [DOI: 10.1016/j.jvoice.2017.08.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/28/2017] [Accepted: 08/28/2017] [Indexed: 11/28/2022]
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17
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Hsin LJ, Lin WN, Fang TJ, Lee LA, Kang CJ, Huang BS, Lin CY, Fan KH, Tsang NM, Hsu CL, Chang JTC, Liao CT, Yen TC, Chang KP, Chuang HF, Li HY. Life quality improvement in hoarse patients with early glottic cancer after transoral laser microsurgery. Head Neck 2017; 39:2070-2078. [PMID: 28695624 DOI: 10.1002/hed.24873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/11/2017] [Accepted: 05/29/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the recovery kinetics of voice and quality of life (QOL) over time in patients with early glottic cancer who underwent transoral laser microsurgery (TLM). METHODS A prospective cohort study was conducted in which acoustic and aerodynamic voice assessments and QOL analyses were done using health-related questionnaires (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions [EORTC-QLQ-C30] and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35-questions [EORTC-QLQ-H&N35]) were administered at designated times. RESULTS Most voice laboratory parameters worsened during the first month, then recovered to baseline after 6 months. The QLQ-H&N35 speech subscale was significantly improved. Among the voice laboratory parameters, pretreatment harmonics-to-noise ratio was an independent predictor (P = .041) for improvement on the speech subscale at the endpoint. CONCLUSION Despite an initial deterioration of voice and QOL in the first month, patients who underwent TLM recovered to a plateau since the sixth month and then to better than preoperative status afterward. A greater improvement in QOL was seen in patients with poorer baseline voice quality.
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Affiliation(s)
- Li-Jen Hsin
- Department of Otolaryngology, Head and Neck Surgery, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wan-Ni Lin
- Department of Otolaryngology, Head and Neck Surgery, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tuan-Jen Fang
- Department of Otolaryngology, Head and Neck Surgery, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Ang Lee
- Department of Otolaryngology, Head and Neck Surgery, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Jan Kang
- Department of Otolaryngology, Head and Neck Surgery, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Bing-Shan Huang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Departmen of Radiation Oncology, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chien-Yu Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Departmen of Radiation Oncology, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kang-Hsing Fan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Departmen of Radiation Oncology, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ngan-Ming Tsang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Departmen of Radiation Oncology, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Cheng-Lung Hsu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Medical Oncology, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Joseph Tung-Chieh Chang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Departmen of Radiation Oncology, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chun-Ta Liao
- Department of Otolaryngology, Head and Neck Surgery, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tzu-Chen Yen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nuclear Medicine and Molecular Imaging, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kai-Ping Chang
- Department of Otolaryngology, Head and Neck Surgery, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Feng Chuang
- Department of Otolaryngology, Head and Neck Surgery, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsueh-Yu Li
- Department of Otolaryngology, Head and Neck Surgery, Linkou-Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
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18
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Chung SY, Kim KH, Keum KC, Koh YW, Kim SH, Choi EC, Lee CG. Radiotherapy Versus Cordectomy in the Management of Early Glottic Cancer. Cancer Res Treat 2017; 50:156-163. [PMID: 28301924 PMCID: PMC5784634 DOI: 10.4143/crt.2016.503] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/10/2017] [Indexed: 11/21/2022] Open
Abstract
Purpose The purpose of this study was to compare the treatment outcomes of definitive radiotherapy (RT) with cordectomy in patients with early glottic cancer. Materials and Methods A total of 165 patients who were diagnosedwith T1/2 squamous cell carcinoma of the glottic larynx between January 2006 and December 2012 were retrospectively analyzed. A total of 112 patients received RT and 53 patients received cordectomy. Local control (LC), disease-free survival (DFS), overall survival (OS), and larynx preservation rates after RT and cordectomy were investigated. Results The median follow-up period was 77.7 months (range, 10.7 to 127.0 months). The 3- and 5-year LC rates were 91.9% and 89.9%, respectively, for the RT group, and 82.8% and 73.2%, respectively, for the cordectomy group (p=0.006). The 3- and 5-year DFS rates were 87.5% and 83.7%, respectively, for the RT group and 79.2% and 68.0%, respectively, for the cordectomy group (p=0.046). No significant differences were identified in the 5-year OS (92.8% vs. 90.6%, p=0.713) or larynx preservation rates (98.2% vs. 97.2%, p=0.831) between groups. The major failure pattern was local failure (n=26), followed by regional (n=3) and distant failure (n=2). Multivariate analysis of LC showed that T2 stage (p=0.012) and receiving cordectomy as initial treatment (p=0.001) were significantly associated with poorer LC. Conclusion RT resulted in higher rates of LC and DFS compared to cordectomy for early glottic cancer. Treatment with radiotherapy is feasible and should be encouraged for both T1 and T2 glottic cancer.
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Affiliation(s)
- Seung Yeun Chung
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Hwan Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Chang Keum
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Chang Choi
- Department of Otorhinolaryngology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Geol Lee
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
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Health-related Quality of Life as Studied by EORTC QLQ and Voice Handicap Index Among Various Patients With Laryngeal Disease. J Voice 2017; 31:251.e17-251.e26. [DOI: 10.1016/j.jvoice.2016.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/08/2016] [Accepted: 07/15/2016] [Indexed: 11/19/2022]
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20
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Brady JS, Marchiano E, Kam D, Baredes S, Eloy JA, Park RCW. Survival Impact of Initial Therapy in Patients with T1-T2 Glottic Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2016; 155:257-64. [DOI: 10.1177/0194599816638085] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/18/2016] [Indexed: 01/26/2023]
Abstract
Objective Laryngeal cancer most commonly arises from the glottis. Comparable outcomes in survival have been shown in patients with early glottic squamous cell carcinoma treated with either surgery or radiotherapy. Study Design and Setting Administrative database study. Subjects and Methods The US National Cancer Institute’s SEER database (Surveillance, Epidemiology, and End Results) was queried for cases of early glottic cancer (T1-T2N0M0, 1988-2012). We identified 13,312 qualifying cases. Patient demographics, therapeutic measures, and survival outcomes were examined with appropriate univariate and multivariate analyses. Results Early glottic cancer has a mean age at diagnosis of 64.8 ± 11.6 years and a male:female ratio of 6.9:1. The most common treatment modality was radiotherapy alone (51.6%), followed by combination therapy with surgery first (31.5%). Overall, the 5-year disease-specific survival (DSS) rate was 88.4%. When stratified by treatment modality and stage, 5-year DSS for T1 tumors was 93.2% with surgery alone and 89.0% with radiation alone ( P < .0001). With combination therapy, the 5-year DSS was 91.3% for surgery first and 84.9% for radiation first ( P = .0239). In T2 tumors, 5-year DSS was improved with single-modality therapy versus multimodality therapy (81.1% vs 76.4; P = .0255). Conclusion In T1 disease, surgery alone shows improved 5-year DSS versus radiation alone, but this difference was not observed in T2 tumors. Additionally, surgery, rather than radiation, shows improved 5-year DSS when implemented as a first-line therapy. Combination therapy does not show improved 5-year DSS for early glottic cancer.
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Affiliation(s)
- Jacob S. Brady
- Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Emily Marchiano
- Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - David Kam
- Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Soly Baredes
- Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Richard Chan Woo Park
- Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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21
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Mandelbaum RS, Abemayor E, Mendelsohn AH. Laryngeal Preservation in Glottic Cancer. Otolaryngol Head Neck Surg 2016; 155:265-73. [DOI: 10.1177/0194599816639248] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 02/25/2016] [Indexed: 12/27/2022]
Abstract
Objective When total laryngectomy is not required, organ preservation surgery or radiotherapy is considered the standard of care for primary glottic cancer. These accepted treatment options are available for early and advanced glottic cancers due to equivalent locoregional control and survival rates. However, in today’s climate of accountable care, the financial burden of treatment choices continues to increase in significance. We therefore compared hospital charges and treatment-related morbidity between organ-preserving surgery and radiation with or without chemotherapy—herein, (chemo)radiation—in the primary treatment of glottic cancer. Study Design Nationwide Inpatient Sample Database was analyzed to assess clinical and financial information. Setting Population-based analysis. Subjects Patients (N = 5499) with primary glottic cancer undergoing treatment with laryngeal preservation strategies. Methods Patients were subdivided by ICD-9 codes into 3 treatment groups: endoscopic resection, open partial laryngectomy, and (chemo)radiation. Treatment-related outcomes, charges, and length of hospitalization were analyzed among treatment groups. Results When adjusting for sex, age, race, comorbidity, and primary payer, (chemo)radiotherapy was associated with increased direct charges ( P < .001; coefficient, $23,658.99; 95% confidence interval [95% CI]: $10,227.15-$37,090.84) and length of hospitalization ( P < .001; hazard ratio, 0.593; 95% CI: 0.502-0.702) when compared with endoscopic surgery. As compared with open surgery, endoscopic surgery was associated with reduced hospital charges ( P = .012; coefficient, $11,967.01; 95% CI: $2,784.17-$21,249.85) and duration of hospitalization ( P < .001; hazard ratio, 0.749; 95% CI: 0.641-0.876). Conclusions This analysis suggests that increased utilization of endoscopic surgery in patients with primary glottic cancer not requiring total laryngectomy may lead to reduced financial burden and duration of hospitalization when compared with open surgery or (chemo)radiation therapy.
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Affiliation(s)
- Rachel S. Mandelbaum
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California–Los Angeles, Los Angeles, California, USA
| | - Elliot Abemayor
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California–Los Angeles, Los Angeles, California, USA
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at the University of California–Los Angeles, Los Angeles, California, USA
| | - Abie H. Mendelsohn
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California–Los Angeles, Los Angeles, California, USA
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at the University of California–Los Angeles, Los Angeles, California, USA
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Pattern of failure in 5001 patients treated for glottic squamous cell carcinoma with curative intent - A population based study from the DAHANCA group. Radiother Oncol 2016; 118:257-66. [PMID: 26897514 DOI: 10.1016/j.radonc.2016.02.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 01/25/2016] [Accepted: 02/04/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE To describe the pattern of failure in a national consecutive cohort of patients with glottic squamous cell carcinomas (SCC) treated with primary radiotherapy (RT) with curative intent over a 41-year period. MATERIALS AND METHODS All patients undergoing curative treatment for a glottic SCC diagnosed in Denmark between 1971 and 2011 were included and followed from the first contact with the oncology center to death or February 15, 2015. RESULTS 5001 patients were identified of whom 98% had primary RT. The median follow-up was 9.1 years/5.7 years (patients alive/patients who died). Ten patients were lost to follow-up. In total 1511 failures were observed; of these 93%, 11% and 5% included T site, N site, and M site, respectively. For patients diagnosed in the 70s and the 00s, respectively, the five-year incidences were: local failure (32% vs 19%), loco-regional failure (34% vs 21%), laryngectomy (26% vs 10%), laryngectomy-free survival (48% vs 62%), disease-free survival (62% vs 68%), and overall survival (62% vs 68%). The five-year incidence of ultimate failure (13-16%) remained statistically unchanged. CONCLUSION From the 70s to the 00s a continually improving primary disease-control was observed with a concurrent decrease in the incidence of laryngectomy. The survival rate was significantly higher in the 00s compared to the previous three decades.
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23
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Sotirović J, Grgurević A, Mumović G, Grgurević U, Pavićević L, Perić A, Erdoglija M, Milojević M. Adaptation and Validation of the Voice Handicap Index (VHI)-30 into Serbian. J Voice 2015; 30:758.e1-758.e6. [PMID: 26452617 DOI: 10.1016/j.jvoice.2015.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 09/03/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the internal consistency, test-retest reliability, and clinical validity of the Serbian version of the self-administered Voice Handicap Index (VHI)-30. STUDY DESIGN Cross-sectional study. METHODS The English version of VHI-30 was translated into Serbian and then back-translated into English. The Serbian VHI-30 was administered to 91 patients divided into four groups according to voice pathology: structural, inflammatory, neurologic, and functional groups. The control group included 90 subjects with no voice problems. The internal consistency (Cronbach's alpha coefficient α), test-retest reliability (interclass correlation coefficient) of VHI-30, comparison of patient's and control's VHI-30 scores (Mann-Whitney U test; Kruskal-Wallis test), and correlation with overall severity of dysphonia (Spearman correlation coefficient, ρ) were calculated. RESULTS In the patient group, we observed excellent internal consistency for the Serbian VHI-30 (α = 0.95) and good internal consistency for all VHI-30 subscales: physical (α = 0.88), functional (α = 0.88), and emotional (α = 0.88). The interclass correlation coefficient indicated strong test-retest reliability for patients (0.99) and controls (0.84). The mean scores of all 30 items in dysphonic participants were significantly higher than in controls (P < 0.001). Good correlation was obtained between the total scores of VHI-30 and patients' self-perceived overall severity of dysphonia (ρ = 0.748, P < 0.001). Within the patient group, the female participants displayed significantly higher VHI-30 scores than male participants (Mann-Whitney U test, P < 0.001). The VHI-30 scores showed strong correlation within different patient groups and controls (Spearman correlation coefficient: structural, 0.942; inflammatory, 0.756; neurologic, 0.888; functional, 0.982; controls, 0.882). CONCLUSIONS The Serbian VHI-30 is a useful and valuable tool for the evaluation of patients with vocal disorders and for making subsequent clinical decisions.
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Affiliation(s)
- Jelena Sotirović
- Clinic for Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia.
| | - Anita Grgurević
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Gordana Mumović
- Department of Ear, Nose and Throat Diseases, Faculty of Medicine, University of Novi Sad, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Uglješa Grgurević
- Clinic for Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia
| | - Ljubomir Pavićević
- Clinic for Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia
| | - Aleksandar Perić
- Clinic for Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia
| | - Milan Erdoglija
- Clinic for Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia
| | - Milanko Milojević
- Clinic for Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia
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