Faculty Member, Professor Hacettepe University Ankara, Turkey
Objectives: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, however, there is a tendency towards better voice outcome after TLM compared to the past.
Methods: Retrospective, tertiary referral center. 165 patients with a precancerous or cancer. lesion involving more than 2/3 of one membranous vocal fold underwent cordectomy type 1 (n=55) (C1 group) or type 2 (n=53) (C2 group) or RT (n=57) (RT group). GRBAS-I, videolaryngostroboscopy, VHI-30, acoustic analysis including F0, jitter, shimmer, NHR, CPP and CSID using running speech, and aerodynamic analysis were performed before treatment, 6 and 24 months after treatment.
Results: Study groups did not differ significantly on pretreatment voice outcomes (p>0.05). RT group had significantly better voice outcomes at 6 months posttreatment compare to C1 and C2 (p < 0.05). C1 had significantly better voice outcomes at 6 months posttreatment compared to C2 (p < 0.05). C1 had significantly better voice outcomes at 24 months posttreatment compared to RT and C2 (p < 0.05). RT and C2 did not differ significantly at 24 months posttreatment (p>0.05).
Conclusions: RT led to better voice outcomes early after treatment of T1a glottic cancer compared to C1 and C2; however, voice outcomes seem to equalize in the long term. C1 appears to have better voice outcomes compared to RT and C2.