scholarly journals Voice Outcomes after Radiotherapy for Laryngeal Cancer

2021 ◽  
Vol 07 (02) ◽  
pp. 096-104
Author(s):  
Jidapa Bridhikitti ◽  
Chanticha Chotigavanich ◽  
Nantakan Apiwarodom
Keyword(s):  
Radiation Dose ◽  
Cancer Patients ◽  
Laryngeal Cancer ◽  
Glottic Cancer ◽  
Lower Radiation Dose ◽  
Conventional Radiation ◽  
Voice Outcome ◽  
The Voice ◽  
Xerostomia Questionnaire

Abstract Objective The study was aimed to assess changes in voice outcomes after radiotherapy in laryngeal cancer patients. Materials and Methods The study included 60 laryngeal cancer patients treated with definitive radiotherapy or chemoradiotherapy between 2005 and 2012. The primary endpoint of this study was to assess abnormalities of the patients’ voices after the treatment. The Thai version of the Voice Handicap Index (VHI) and xerostomia questionnaire were conducted by telephone. Videostroboscopic examination was done to objectively assess voice outcomes. Results The median age of patients was 63 years. Most patients had glottic cancer (84.1%) and T1–2 disease (84.1%). The median time from treatment to the study was 46 months. In terms of the total VHI score, most patients were in the normal and slight handicap groups (22% and 71.4%, respectively). Only 4.8% and 1.6% of the patients were in moderate and severe handicap group, respectively. Twenty-eight patients had significant xerostomia. Videostroboscopy examination was done in 23 patients and most common findings were telangiectasia (95.7%), abnormal mucosal wave (47.8%), and abnormal glottic closure configuration (34.8%). Regarding total VHI score, lower radiation dose, conventional radiation dose per fraction, longer period after treatment, and significant xerostomia status were significantly correlated with worse voice outcomes. There were no statistically significant correlations between the videostroboscopic findings and VHI scores. Conclusion Voice outcomes in most of laryngeal cancer patients treated with radiotherapy had a normal or mild handicap at more than 1 year of follow-up. Only 4.8% and 1.6% of the patients had moderate and severe voice outcome handicap, respectively.

Longitudinal analysis of Voice Handicap Index in early glottic cancer patients treated with transoral laser microsurgery: age, gender, stage and time dependence

2019 ◽  
Vol 133 (4) ◽  
pp. 318-323 ◽  
Author(s):  
C Lane ◽  
M Rigby ◽  
R Hart ◽  
J Trites ◽  
E Levi ◽  
...  
Keyword(s):  
Voice Handicap Index ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Early Glottic Cancer ◽  
Related Quality ◽  
The Voice

AbstractObjectivesTransoral laser microsurgery is an increasingly common treatment modality for glottic carcinoma. This study aimed to determine the effect of age, gender, stage and time on voice-related quality of life using the Voice Handicap Index-10.MethodsPrimary early glottic carcinoma patients treated with transoral laser microsurgery were included in the study. Self-reported Voice Handicap Index testing was completed pre-operatively, three months post-operatively, and yearly at follow-up appointments.ResultsVoice Handicap Index improvement was found to be dependent on age and tumour stage, while no significant differences were found in Voice Handicap Index for gender. Voice Handicap Index score was significantly improved at 12 months and 24 months. Time versus Voice Handicap Index modelling revealed a preference for non-linear over linear regression.ConclusionAge and stage are important factors, as younger patients with more advanced tumours show greater voice improvement post-operatively. Patient's Voice Handicap Index is predicted to have 95 per cent of maximal improvement by 5.5 months post-operatively.

Severe late dysphagia after multimodal treatment of stage III/IV laryngeal and hypopharyngeal cancer

2019 ◽  
Vol 50 (2) ◽  
pp. 185-192 ◽  
Author(s):  
Gene Huh ◽  
Soon-Hyun Ahn ◽  
Jun-Girl Suk ◽  
Min-Hyung Lee ◽  
Won Shik Kim ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Laryngeal Cancer ◽  
Multimodal Treatment ◽  
Concurrent Chemoradiotherapy ◽  
Primary Treatment ◽  
Hypopharyngeal Cancer ◽  
Stage Iii ◽  
Laryngeal Function ◽  
Significant Difference

Abstract Background Long-term side effects after radiotherapy for organ preservation ‘could deteriorate’ the laryngeal function. This study intended to identify the incidence of severe late dysphagia following the multimodal treatment for stage III/IV laryngeal and hypopharyngeal cancer ‘to evaluate the function of larynx’. Methods The medical records of patients successfully treated for laryngeal and hypopharyngeal cancer with a multimodal approach, including radiotherapy, were retrospectively analyzed. ‘Functional larynx was defined as tolerable oral diet without severe late dysphagia or tracheostoma’. Results The study included 99 patients with a median follow-up period of 72 months. ‘Tracheostomy during the follow-up period was required in only one patient due to aspiration pneumonia, and dysphagia is the main determinant for functional larynx’. The probability of maintaining functional larynx was 63% for 10 years, when the treatment was started with radiotherapy or concurrent chemoradiotherapy. In upfront surgery (operation first and adjuvant radiotherapy/concurrent chemoradiotherapy) group, 37% of patients required total laryngectomy as primary treatment and 43% of patients could maintain laryngeal function for 10 years. And severe late dysphagia in the latter group developed mainly after laryngeal preservation surgery. The patients aged ≥65 years showed significantly higher incidence of dysphagia. Severe late dysphagia was very rare in laryngeal cancer successfully cured with radiotherapy/concurrent chemoradiotherapy (1/25, 4%); however, it gradually increased over time in hypopharyngeal cancer patients showing a statistically significant difference from laryngeal cancer patients (P = 0.040). Conclusion Severe late dysphagia occurred in 19.2% of patients treated for laryngeal and hypopharyngeal cancers, regardless of whether treatment started with radiotherapy/concurrent chemoradiotherapy or surgery.

Multimodal Evaluation of Voice Outcome in Early Glottic Cancers Treated With Definitive Radiotherapy

2021 ◽  
Vol 1 (3) ◽  
pp. 143-149
Author(s):  
MARIANNA TRIGNANI ◽  
ANGELO DI PILLA ◽  
CONSUELO ROSA ◽  
MARZIA BORGIA ◽  
DAVID FASCIOLO ◽  
...  
Keyword(s):  
Glottic Cancer ◽  
Early Glottic Cancer ◽  
Vocal Cord Motion ◽  
Voice Outcome ◽  
Speech Pathologist ◽  
Primary Radiotherapy ◽  
Evaluation Of Parameters ◽  
Speech Therapist

Background/Aim: We employed a multimodal evaluation of voice outcome (MEVO) model to assess long-term voice outcome in early glottic cancer (EGC) patients treated with primary radiotherapy (RT). The model consisted of objective and subjective vocal evaluation during follow-up, by a dedicated Speech Pathologist and Speech Therapist. Patients and Methods: MEVO methodology includes Self-perception Voice Handicap Index (VHI-30), evaluation of parameters Grade (G), Roughness (R), Breathiness (B), Asthenia (A) and Strain (S) according to GRBAS scale, objective analysis and aerodynamics using the PRAAT software and laryngeal evaluation with videostroboscope (VS). Results: The MEVO methodology was described and tested on a sample of 10 EGCs submitted to definitive RT (total dose 66-70 Gy). Mean follow-up was 48.9 months (range=9-115). VHI was mild-moderate in 90% of patients; overall voice function (GRBAS) was normal-mildly impaired in 70% of patients; VS evaluation showed normal vocal cord motion in 90% of patients, but complete glottic closure in 60%. PRAAT scores confirmed these findings. Conclusion: A multidimensional voice evaluation is time consuming, but useful to objectify vocal impact of radiotherapy. The MEVO model allowed to quantify vocal dysfunction, showing a good objective vocal outcome.

Long-Term Taste Impairment after Intensity-Modulated Radiotherapy to Treat Head-and-Neck Cancer: Correlations with Glossectomy and the Mean Radiation Dose to the Oral Cavity

2019 ◽  
Vol 44 (5) ◽  
pp. 319-326 ◽  
Author(s):  
Wen-Cheng Chen ◽  
Ming-Shao Tsai ◽  
Yao-Te Tsai ◽  
Chia-Hsuan Lai ◽  
Chuan-Pin Lee ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Oral Cavity ◽  
Head And Neck ◽  
Cancer Patients ◽  
Intensity Modulated Radiotherapy ◽  
Intensity Modulated ◽  
Patient Reported ◽  
The Mean

AbstractWe explored the effects of various parameters on taste impairments (TIs) in head-and-neck (H&N) cancer patients receiving intensity-modulated radiotherapy (IMRT). From January 2014 to September 2017, 88 H&N cancer patients subjected to curative or postoperative IMRT were enrolled in this prospective study. All patients underwent at least 1 year of follow-up after IMRT. Quality-of-life assessments in terms of patient-reported gustatory function were measured using the taste-related questions of the European Organization for Research and Treatment of Cancer H&N35 questionnaires. At a median follow-up time of 27 months, 27 of 88 patients (30.7%) reported long-term TIs. In multivariate analyses, glossectomy most significantly predicted TIs (P = 0.04). The percentage of TIs (61.5%) was significantly (P = 0.03) higher in patients who underwent partial or total glossectomy than in patients who did not undergo surgery (28.0%) and those who underwent radical surgery without glossectomy (20.0%). When we excluded surgical patients from analyses, the mean radiation dose to the oral cavity was of borderline significance in terms of TI prediction (P = 0.05). Only 10.5% of patients suffered from TIs when the mean radiation dose was <5000 cGy compared with 38.7% when the mean dose was ≥5000 cGy. In conclusion, glossectomy is the major cause of long-term TIs in H&N cancer patients receiving IMRT. In patients who do not undergo glossectomy, reduction of the mean radiation dose to the oral cavity may reduce TIs after IMRT.

The Irradiated Larynx and Voice

1983 ◽  
Vol 26 (4) ◽  
pp. 482-485 ◽  
Author(s):  
Margaret L. Stoicheff ◽  
Antonio Ciampi ◽  
Jean E. Passi ◽  
John M. Fredrickson
Keyword(s):  
Radiation Therapy ◽  
Cancer Patients ◽  
Laryngeal Cancer ◽  
Normal Subjects ◽  
Control Group ◽  
Perceptual Evaluation ◽  
Quantitative Rating ◽  
Male Patients ◽  
The Voice

The voices of patients with laryngeal cancer following a specific radiotherapy regimen were subjected to perceptual evaluation. Interval scaling of the severity of perceived dysphonia was completed for the voices of male patients sampled before and 1 year following radiation therapy and for a set of male controls. Eight listeners did this quantitative rating and also specified the predominant quality in each voice. The results indicated that the degree of dysphonia in the pretreatment group was highest. Radiotherapy decreased this dysphonia but not to the point that posttreatment voices were indistinguishable from those of normal subjects. Also, the voice qualities of laryngeal cancer patients shifted toward those of the control group following radiotherapy with over one half of the irradiated patients judged to have rough or normal qualities.

Second primary tumours of the larynx following bronchial carcinoma

1990 ◽  
Vol 104 (8) ◽  
pp. 629-630 ◽  
Author(s):  
G. W. McGarry ◽  
Ed. K. Mackenzie
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Laryngeal Cancer ◽  
Bronchial Carcinoma ◽  
Second Primary ◽  
Bronchial Cancer ◽  
Lung Cancer Patients ◽  
Multiple Primary Malignancies ◽  
Second Primary Tumours

AbstractThe occurrence of multiple primary malignancies in patients with laryngeal cancer is well known. The possibility that lung cancer patients may be at risk of subsequent laryngeal cancer is less well recognized. The possibility of laryngeal cancer developing later has implications for the follow-up of lung cancer patients.Three cases of subsequent laryngeal primary cancer occurring in survivors of bronchial cancer are presented and the implications are discussed.

Tracheoesophageal Puncture in Irradiated Patients

1995 ◽  
Vol 104 (4) ◽  
pp. 279-281 ◽  
Author(s):  
Anthony LaBruna ◽  
Jerry Huo ◽  
Iris Klatsky ◽  
Michael H. Weiss
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Laryngeal Cancer ◽  
Postoperative Radiotherapy ◽  
Primary Treatment ◽  
Voice Prosthesis ◽  
Vocal Rehabilitation ◽  
Excellent Method ◽  
Tracheoesophageal Puncture

Tracheoesophageal puncture (TEP) with use of a voice prosthesis is widely accepted as an excellent method of postlaryngectomy vocal rehabilitation. Many patients with advanced cancer require postoperative radiotherapy (RT), while other cancer patients have been treated with RT as a primary treatment and come to laryngectomy for salvage. The influence of RT on outcome of the TEP procedure with respect to successful speech and potential complications has not been widely discussed. We retrospectively reviewed 77 consecutive cases of TEP in patients who had received RT and laryngectomy for laryngeal cancer. All cases had a minimum of 6 months of follow-up. All 77 patients were successful in obtaining speech with the TEP, and 75 (97%) continued to be TEP users thereafter. Eight patients (10%) developed complications in the course of treatment. There was no mortality. In selected patients, TEP after RT is a relatively safe and effective method of vocal rehabilitation.

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