Current treatment of T1N0 squamous cell carcinoma of the glottic larynx

Mendenhall, William M.; Takes, Robert P.; Shah, Jatin P.; Bradley, Patrick J.; Beitler, Jonathan J.; Strojan, Primož; Suárez, Carlos; Rodrigo, Juan P.; Saba, Nabil F.; Rinaldo, Alessandra; Werner, Jochen A.; Ferlito, Alfio

doi:10.1007/s00405-014-3388-5

Cited by 7 publications

(4 citation statements)

References 25 publications

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“…Radiotherapy (RT) and transoral endoscopic laser surgery are the treatments of choice for early (T1N0M0) glottic cancer 1, 2. In these cases, the aim of treatment is not only the eradication of the tumor, but also the preservation of larynx functions 3.…”

Section: Introductionmentioning

confidence: 99%

“…In these cases, the aim of treatment is not only the eradication of the tumor, but also the preservation of larynx functions 3. The choice between the two treatment options should be adjusted for each patient based on tumor characteristics, her/his medical condition and personal preferences, anticipated treatment morbidity with their quality of voice as the priority, and, additionally, based on costs 2. Even though the studies showed that RT is more expensive than endoscopic laser surgery, RT still remains the preferred treatment modality in many oncological centres due to the presumably better voice quality outcome 1, 2, 3, 4, 5.…”

Section: Introductionmentioning

confidence: 99%

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Factors affecting voice quality in early glottic cancer before and after radiotherapy

Mekis

Strojan

Boltežar

2019

Radiology and Oncology

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BackgroundRadiotherapy (RT) is a successful mode of treatment for early glottic cancer. The aim of the study was to assess voice quality both before and 3 months after successful RT using multimodal methods while also identifying the factors affecting it.Patients and methodsIn 50 patients with T1 glottic carcinoma, the subjective (patients’ assessment of voice quality [VAS], Voice Handicap Index [VHI] questionnaire, phoniatricians’ assessment using the grade/roughness/ breathiness [GRB] scale), and objective assessments (fundamental laryngeal frequency [F0], jitter, shimmer, maximum phonation time [MPT]) of voice quality were performed before RT and 3 months post-RT. The data on gender, age, extent of the tumors, biopsy types, smoking, local findings, and RT were obtained from the medical documentation.ResultsThree months after the treatment, VAS, VHI, G and R scores, F0, and MPT significantly improved in comparison with their assessment prior to treatment. Before the treatment, the involvement of the anterior commissure significantly deteriorated jitter (p = 0.044) and the involvement of both vocal folds deteriorated jitter (p = 0.003) and shimmer (p = 0.007). After the RT, F0 was significantly higher in the patients with repeated biopsy than in the others (p = 0.047). In patients with post-RT changes, the B score was significantly higher than in those without post-RT changes (p = 0.029).ConclusionsVoice quality already significantly improved three months after the treatment of glottic cancer. The main reason for the decreased voice quality prior to treatment is the tumor’s extent. Post-RT laryngeal changes and repeated biopsies caused more scarring on vocal folds adversely influencing voice quality after the treatment.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors affecting voice quality in early glottic cancer before and after radiotherapy

Mekis

Strojan

Boltežar

2019

Radiology and Oncology

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“…T1-T2 glottic SCC may either be treated with definitive RT or transoral resection (TLR), offering the advantage of voice preservation and similar survival rates [21]. Selection of the patients for either of the two treatment modalities should be based on a more comprehensive assessment of particular clinical scenario and not just on the T-stage criterion, e.g., location and extent of the tumor, medical condition of the patient, and expertise of the attending physician.…”

Section: T1-t2mentioning

confidence: 99%

When is definitive radiotherapy the preferred treatment for head and neck squamous cell carcinoma?

Mendenhall

Strojan

Eisbruch

et al. 2015

Eur Arch Otorhinolaryngol

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“…Therefore, a subjective evaluation of the age of the patient, their occupation, their comorbidities, the tumour location, the extent and depth of the invasion, the accessibility of the treatment modalities, and the expertise of the treatment teams as well as the preference of the patient should be among the factors affecting the decision about which treatment modality to use. When the profession of the patient demands a considerable vocal load and good voice quality, RT is generally suggested as the treatment of choice [ 9 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Change in Voice Quality after Radiotherapy for Early Glottic Cancer

Mekis

Strojan

Mekiš

et al. 2022

Cancers

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Our aim was to track the changes in voice quality for two years after radiotherapy (RT) for early glottic cancer. A videoendostroboscopy, subjective patient and phoniatrician voice assessments, a Voice Handicap Index questionnaire, and objective acoustic measurements (F0, jitter, shimmer, maximal phonation time) were performed on 50 patients with T1 glottic carcinomas at 3, 12, and 24 months post-RT. The results were compared between the subsequent assessments, and between the assessments at 3 months and 24 months post-RT. The stroboscopy showed a gradual progression of fibrosis of the vocal folds with a significant difference apparent when the assessments at 3 months and 24 months were compared (p < 0.001). Almost all of the subjective assessments of voice quality showed an improvement during the first 2 years, but significant differences were noted at 24 months. Jitter and shimmer deteriorated in the first year after RT with a significant deterioration noticed between the sixth and twelfth months (p = 0.048 and p = 0.002, respectively). Two years after RT, only 8/50 (16%) patients had normal voices. The main reasons for a decreased voice quality after RT for early glottic cancer were post-RT changes in the larynx. Despite a significant improvement in the voice after RT shown in a few of the evaluation methods, only a minority of the patients had a normal voice two years post-RT.

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Current treatment of T1N0 squamous cell carcinoma of the glottic larynx

Cited by 7 publications

References 25 publications

Factors affecting voice quality in early glottic cancer before and after radiotherapy

Factors affecting voice quality in early glottic cancer before and after radiotherapy

When is definitive radiotherapy the preferred treatment for head and neck squamous cell carcinoma?

Change in Voice Quality after Radiotherapy for Early Glottic Cancer

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