A comparative study of short-term phonatory outcomes in primary cases of early glottic cancer treated with radiotherapy versus laser surgery

Abstract

Early-stage glottic carcinomas can be treated with either laser surgery or radiotherapy. Both approaches have demonstrated similar cure rates. However, the question of which modality is superior in terms of voice outcomes remains a topic of debate. In our study, we conducted a comparison of short-term phonatory outcomes in patients with primary early glottic cancer who underwent treatment using both modalities. We assessed these outcomes using videostroboscopy and voice analysis software at three time points: immediately following treatment, at 1 month, and at 3 months post-treatment. Voice analysis revealed that laser surgery had a more favorable immediate effect compared to radiotherapy in parameters such as jitter, shimmer, harmonics-to-noise ratio, and fundamental frequency. However, at the 3-month post-treatment mark, both treatment modalities demonstrated similar effects. Additionally, both modalities had comparable effects on maximum phonation time. Videostroboscopy observations showed that mucosal wave forms were more prominent immediately after laser surgery and gradually improved following radiotherapy. Furthermore, patients with incomplete glottic closure experienced recovery after both treatment modalities. Based on the results, there are better outcomes immediately following LS compared to RT. However, after a 3-month period, the outcomes of both treatment modalities become comparable. The treating physicians must consider various factors such as complications, patient-specific considerations, treatment costs, and duration to make informed decisions. A personalized approach considering the individual patient’s circumstances is crucial in achieving optimal results in the management of T1 laryngeal cancer.