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

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.

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Voice outcomes following transoral laser microsurgery for early glottic squamous cell carcinoma

The Journal of Laryngology & Otology ◽

10.1017/s0022215107007554 ◽

2007 ◽

Vol 121 (12) ◽

pp. 1184-1188 ◽

Cited By ~ 12

Author(s):

J T Kennedy ◽

P M Paddle ◽

B J Cook ◽

P Chapman ◽

T A Iseli

Keyword(s):

Glottic Cancer ◽

Transoral Laser Microsurgery ◽

Laser Microsurgery ◽

Early Glottic Cancer ◽

Primary Radiotherapy ◽

Second Procedure ◽

European Laryngological Society ◽

Choice Of Therapy ◽

Salvage Laryngectomy

AbstractIntroduction:Early glottic cancer may be treated with primary radiotherapy or transoral laser microsurgery with comparable survival. The choice of therapy therefore depends on patient preference after discussion of risks, benefits and alternatives.Materials and methods:All previously untreated patients undergoing transoral laser microsurgery for T1 or T2 glottic cancer at St Vincent's Hospital between July 1997 and December 2004 had their staging and demographics recorded. Surgery was categorised according to the European Laryngological Society. A voice recording was made pre-operatively then at 12 weeks post-operatively and scored by two independent speech therapists on the Oates Russell Voice Profile – a scale of zero (normal) to five (severe dysphonia). Follow up was for a minimum of two years.Results and analysis:Fifty-three patients with a mean age of 56 were included. The observed survival was T1 89.4 per cent and T2 85.3 per cent after a mean follow up of 47 months. Nineteen patients staged T1 underwent cordectomy. A second procedure was required in 22.2 per cent, however, none required a laryngectomy. Thirty-four patients staged T2 underwent hemilaryngectomy. A second procedure was required in 41.2 per cent including 8.8 per cent requiring salvage laryngectomy. One patient died with unresectable nodal disease. The mean Oates Russell Voice Profile for T1 disease was 2.37 and for T2 2.68 (range 1 to 4) indicating a mild (2) to moderate (3) degree of voice impairment.Conclusions:Survival outcomes following transoral laser microsurgery are comparable to treatment with radiotherapy. Voice impairment is usually mild to moderate following transoral laser microsurgery for early glottic cancer but overall may be greater than in radiotherapy patients. The repeatability of transoral laser microsurgery may result in a lower laryngectomy rate compared with published series using radiotherapy.

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Long-term Voice Outcome Following Radiation Versus Laser Microsurgery in Early Glottic Cancer

Journal of Voice ◽

10.1016/j.jvoice.2017.10.018 ◽

2019 ◽

Vol 33 (2) ◽

pp. 176-182 ◽

Cited By ~ 6

Author(s):

Yue Ma ◽

Rebecca Green ◽

Stephanie Pan ◽

Daniel McCabe ◽

Leanne Goldberg ◽

...

Keyword(s):

Glottic Cancer ◽

Laser Microsurgery ◽

Early Glottic Cancer ◽

Voice Outcome

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OC-0514 Long-term follow up of a RCT of Accelerated Radiotherapy for early Glottic Cancer (JCOG 0701A3)

Radiotherapy and Oncology ◽

10.1016/s0167-8140(21)06940-1 ◽

2021 ◽

Vol 161 ◽

pp. S398-S399

Author(s):

T. Kodaira ◽

Y. Kagami ◽

R. Machida ◽

N. Shikama ◽

Y. Ito ◽

...

Keyword(s):

Glottic Cancer ◽

Early Glottic Cancer ◽

Accelerated Radiotherapy ◽

Long Term Follow Up

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Voice Outcomes after Radiotherapy Treatment for Early Glottic Cancer: Long-Term Follow-Up

Journal of Voice ◽

10.1016/j.jvoice.2017.08.025 ◽

2018 ◽

Vol 32 (5) ◽

pp. 636-642 ◽

Cited By ~ 2

Author(s):

Megan Watson ◽

Allison Drosdowsky ◽

Jacqui Frowen ◽

June Corry

Keyword(s):

Glottic Cancer ◽

Early Glottic Cancer ◽

Long Term Follow Up ◽

Radiotherapy Treatment

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Long-Term Outcome of Definitive Radiotherapy for Early Glottic Cancer: Prognostic Factors and Patterns of Local Failure

Cancer Research and Treatment ◽

10.4143/crt.2014.203 ◽

2015 ◽

Vol 47 (4) ◽

pp. 862-870 ◽

Cited By ~ 20

Author(s):

Yu Jin Lim ◽

Hong-Gyun Wu ◽

Tack-Kyun Kwon ◽

J. Hun Hah ◽

Myung-Whun Sung ◽

...

Keyword(s):

Prognostic Factors ◽

Local Failure ◽

Glottic Cancer ◽

Term Outcome ◽

Long Term Outcome ◽

Early Glottic Cancer ◽

Definitive Radiotherapy

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215119000392 ◽

2019 ◽

Vol 133 (4) ◽

pp. 318-323 ◽

Cited By ~ 2

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.

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