M Bhabra, D Sellstrom, C Robertson, S Rothrie, E Fahy, S H Woodman, D W Hamilton, J M Patterson
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引用次数: 0
Abstract
Background: Early laryngeal cancer is effectively treated with transoral laser microsurgery (TLM) or radiotherapy, both offering comparable oncological outcomes. The impact on voice and swallowing remains unclear.
Objectives: To evaluate voice and swallowing outcomes following treatment with TLM or radiotherapy for early laryngeal cancer in a UK multi-centre prospective study.
Methods: A total of 137 patients with T1 or T2 laryngeal cancer were recruited from five UK head and neck cancer centres. Patients received either TLM or radiotherapy (up to 55 Gy). Voice and swallowing function were assessed at baseline, 3 months and 6 months post-treatment using a multidimensional protocol: Voice Handicap Index (VHI-10), maximum phonation time (MPT), GRBAS perceptual voice scale, 100 mL timed water swallow test and Normalcy of Diet (NoD).
Results: VHI scores improved significantly following radiotherapy at 3 months (MD 8.66, SD 11.46, 95% CI 5.5, 11.8, p < 0.001). MPT was also significantly longer in the radiotherapy group (MD 2.47, SD 6.2, 95% CI 0.7-4.2, p = 0.007). Perceptual voice ratings showed reduced hoarseness post-radiotherapy at 3 months (MD 0.71, SD 1.11, 95% CI 0.43, 0.98, p < 0.001). No significant differences were found between treatments for swallowing function or NoD, which remains stable up to 6 months.
Conclusion: Radiotherapy is associated with better short-term voice outcomes compared to TLM. Swallowing function remains largely unaffected by treatment type. This study highlights the need to include functional outcomes in treatment decisions and is the first UK multicentre prospective study to use standardised, multidimensional assessments of early recovery following treatment for early laryngeal cancer.
期刊介绍：
Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with:
current otorhinolaryngological practice
audiology, otology, balance, rhinology, larynx, voice and paediatric ORL
head and neck oncology
head and neck plastic and reconstructive surgery
continuing medical education and ORL training
The emphasis is on high quality new work in the clinical field and on fresh, original research.
Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject.
• Negative/null results
In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.
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