Effect of vocal rehabilitation after chemoradiation for non-laryngeal head and neck cancers

Sreenivas, Athulya; Sreedharan, Suja; Narayan, Manisha; Balasubramanium, Radish Kumar; Saxena, PU Prakash; Banerjee, Sourjya; Dosamane, Deviprasad; Shenoy, Vijendra S; Kamath, M. Panduranga

doi:10.14639/0392-100x-n0977

Cited by 4 publications

(5 citation statements)

References 27 publications

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“…On the second evaluation, role functioning increased, and senses and speech problems decreased. The improvement of speech could be attributed to the voice rehabilitation therapy that the participants received since these interventions promote an improvement of the voice (12) , in the future, we recommend corroborating this finding using specific and objective measures to evaluate voice related QoL, and voice intensity and frequency.…”

Section: Discussionmentioning

confidence: 63%

“…Voice problems can affect QoL (8) and have been associated with higher levels of depression, anxiety and distress (9)(10)(11) , so adaptive coping strategies can benefit the emotional well-being of H&N cancer patients. Which is why voice rehabilitation has a very important role in the treatment of these patients since it can improve voice quality (12,13) , however, the effectiveness of this intervention requires of treatment adherence (TA) (13,14) .…”

Section: Introductionmentioning

confidence: 99%

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Quality of life, adherence to voice rehabilitation therapy and psychological variables in patients with head and neck cancer

Toski de Angel,

Galindo-Vázquez,

Contreras Buendia

et al. 2024

Psicooncología

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Introduction: Voice problems can affect quality of life (QoL), other psychological aspects, and the adequate adherence to voice rehabilitation therapy. Objective: To determine the association between QoL and treatment adherence (TA) to voice rehabilitation with symptoms of anxiety, depression, and coping strategies. Method: A longitudinal study was conducted with 97 participants with head and neck cancer (H&N) who were attending voice rehabilitation therapy. Instruments: EORTC QLQ-C30 and QLQ-H&N35, Treatment Adherence Checklist, Cancer Coping Questionnaire and HADS. Results: The mean overall QoL was 83.33, and mean TA was 8.80. Lower overall QoL and emotional functioning scores, as well as higher dry mouth scores were associated with higher levels of anxiety. Greater problems with social contact and lower TA were associated to higher depression scores. Conclusion: Consistent with the literature, TA and QoL were associated to depression and QoL was also correlated to anxiety. These results are among the first to explore such aspects in Latino patients and emphasize the importance of multidisciplinary care for H&N cancer patients in voice rehabilitation therapy, given that during their treatment they may encounter psychological barriers that could hinder their progress in voice quality and QoL.

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Section: Discussionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Quality of life, adherence to voice rehabilitation therapy and psychological variables in patients with head and neck cancer

Toski de Angel,

Galindo-Vázquez,

Contreras Buendia

et al. 2024

Psicooncología

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“…Therefore, the design of a questionnaire that considers the main functional disorders in a balanced way would reflect the extent to which the alterations are related to QoL and the therapeutic modality used, both surgical (total laryngectomy, supraglottic) and CRT. They would therefore be a guide to indicate different supportive and rehabilitation therapies, as suggested by other authors 2 , 6 , 26 . Our group is conducting a study similar to the present one in the same group of patients but with diagnostic instruments and QoL questionnaires for swallowing disorders 22 .…”

Section: Discussionmentioning

confidence: 94%

Voice outcomes in patients with advanced laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy

Álvarez-Marcos

Vicente-Benito

Gayol-Fernández

et al. 2022

Acta Otorhinolaryngol Ital

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SUMMARY 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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Section: Discussionmentioning

confidence: 99%

“…LCGs presumably develop as a result of the compensatory vocal action secondary to radiation-induced voice alteration. Recently, Sreenivas et al(21) successfully used voice rehabilitation to alleviate inefficient compensatory vocal behavior and improve vocal performance in patients with non-laryngeal head and neck tumors after radiation.Eliminating causative risk factors constitutes the first step in LCG management(2). Generally, laryngeal granulomas are divided by etiology into spontaneous granulomas and iatrogenic granulomas(22).…”

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confidence: 99%

Laryngeal contact granuloma after radiotherapy in patients with nasopharyngeal carcinoma: a case series

Mo¹,

Chen²,

Huang³

et al. 2023

Ann Transl Med

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Background Laryngeal contact granuloma (LCG) is a benign hypertrophic lesion and phonatory injury after abnormal vocal behavior is regarded as its major etiology. Patients receiving radiation for non-laryngeal head and neck tumors are troubled by persistent voice impairment. The occurrence of LCG after radiotherapy for nasopharyngeal carcinoma (NPC) in our practice has implored us to re-exam their underlying etiology. We hypothesize that a proportion of LCG results from voice change caused by non-laryngeal head and neck cancer radiotherapy and firstly describe a distinct LCG population originated after radiotherapy for NPC with respect to the clinical profile, presentation, prognosis and response to treatment of patients. Methods We retrospectively reviewed the laryngoscopic examination and tumor study findings to elucidate the common clinical features of patients who presented with LCG after radiotherapy for NPC. All patients were regularly monitored with telescopic examination until lesions disappeared. Data on age, sex, clinical presentation, telescopic findings, management, latency time of lesion formation, remission time and clinical outcome were reviewed. Results The medical review identified 27 cases of LCG secondary to radiotherapy for NPC. All lesions had been diagnosed during routine endoscopy following radiation. The interval between radiation onset and endoscopic diagnosis was 3.77 months (range, 0.67–11 months). 20 cases were resolved through simple observation, 4 cases were resolved with the administration of proton pump inhibitors (PPIs), and 3 cases with a poor response to PPI therapy required subsequent surgical resection. The mean remission time in the observation and PPI groups was 4.42 months (range, 0.73–18.9 months) and 5.78 months (range, 2.17–14.63 months), respectively. All patients recovered completely and none experienced recurrence during a mean follow-up of 32.44 months (range, 5.6–71.67 months). Conclusions Iatrogenic granulomas of vocal process are presenting after radiation for non-laryngeal head and neck cancers. In contrast with spontaneous granulomas, these granulomas can be cured at high remission rates and low recurrence trend without specific intervention. Thus, simple observation may be sufficient for radiation-induced LCG.

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Effect of vocal rehabilitation after chemoradiation for non-laryngeal head and neck cancers

Cited by 4 publications

References 27 publications

Quality of life, adherence to voice rehabilitation therapy and psychological variables in patients with head and neck cancer

Quality of life, adherence to voice rehabilitation therapy and psychological variables in patients with head and neck cancer

Voice outcomes in patients with advanced laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy

Laryngeal contact granuloma after radiotherapy in patients with nasopharyngeal carcinoma: a case series

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