Comparison of Partial Laryngectomy Versus Radiotherapy for the Treatment of Early Glottic Carcinoma: Complications and Oncological Results- a Nonrandomized Clinical Trial
Abstract
The aim of this non-randomized clinical trial was to evaluate tumor outcomes and subjective quality of voice following radiotherapy and partial laryngectomy in early-stage glottic laryngeal cancers. Non-Randomized Clinical Trial. Otolaryngology and radiation oncology clinics of Imam Khomeini (an affiliated hospital of Tehran University of Medical Sciences) and Amir Aalam Hospitals. Fifteen patients with early-stage glottic laryngeal carcinoma were admitted to the otolaryngology clinic, divided into two treatment groups: radiotherapy and partial laryngectomy. Of the total 50 patients, 25 had a partial laryngectomy and 25 radiotherapies. The comparison of the average of the Voice Handicap Index (VHI) showed significant improvement of vocal quality after treatment for both partial laryngectomy and radiotherapy (P<0.0001 for both). But there was no significant difference in VHI mean scores between the two treatment groups (patients treated by partial laryngectomy and radiotherapy). Short- and long-term complication was higher in patients undergoing surgery than radiotherapy group (P<0.0001). With regard to oncological outcome after one and eight-year after treatment, no differences were observed in the two treatment groups; there was a significant relationship between smoking cessation and recurrence of disease in the partial laryngectomy treatment group (P=0.012). There was no significant difference in voice quality and life expectancy of patients operated on using open surgery and patients treated with radiotherapy in this series. Open surgery may have more noticeable complications than radiotherapy.
1. Remmelts AJ, Hoebers FJ, Klop WM, Hamming-Vrieze O, van den Brekel MW. Evaluation of lasersurgery and radiotherapy as treatment modalities in early stage laryngeal carcinoma: tumor outcome and quality of voice Eur Arch Otorhinolaryngol 2013;270:2079-87.
2. Sanderson RJ, Ironside JAD. Squamous cell carcinomas of the head and neck. BMJ 2002;325:822-7.
3. Yasmin B, Bhurgri A, Usman A, Pervez S, Kayani N,BashirI, et al. Epidemiological Review of Head and Neck Cancers in Karachi. Asian Pacific J Cancer Prev 2006;7:195-200.
4. Saedi B, Razmpa E, Sadeghi M, Mojtahed M, Mojtahed A. The epidemiology of laryngeal cancer in a country on the esophageal cancer belt. Indian J Otolaryngol Head Neck Surg 2009;61:213-17.
5. Feng Y, Wang B, Wen S. Laser Surgery versus Radiotherapy for T1–T2N0 Glottic Cancer: A Meta-Analysis. ORL J Otorhinolaryngol Relat Spec 2011;73:336-42.
6. Loon YV, Sjeogren EV, Langeveld TPM, Baatenburg de Jong RJ, Schoones JW, van Rossum MA. Functional outcomes after radiotherapy or laser surgery in early glottic carcinoma: A systematic review. Head Neck 2012;34:1179-89.
7. Toma M, Nibu KI, Nakao K, Matsuzaki M, Mochiki, M Yuge T, et al. Partial Laryngectomy to Treat Early Glottic Cancer After Failure of Radiation Therapy. Arch Otolaryngol Head Neck Surg 2002;128:909-12.
8. Graciano AJ, Sonagli M, Clemente da Silva AG, Fischer CA, Chone CT. Partial laryngectomy in glottic cancer: complications and oncological results. Braz J Otorhinolaryngol 2016;82:275-80.
9. Milovanović JP, Djukić VB, Milovanović AP, Trivić AS, Baljosević IS, Vukasinović MM, et al. Functional results of treatment of early carcinoma in the glottic region of the larynx. Acta Chir Iugosl 2009;56:95-100.
10. Arias F, Arraras JA, Asin G, Uzcanga MI, Marav E, Chicata V, et al. Quality of life and voice assessment in patients with early-stage glottic cancer. Head Neck 2015;37:340-6.
11. Andersen LJ, Evensen J, Mortensen HR, Overgaard J. The DAHANCA 6 randomized trial: Effect of 6 vs 5 weekly fractions of radiotherapy in patients with glottic squamous cell carcinoma. Radiother Oncol 2015;117:91-8.
12. Rosier JF, Grégoire V, Counoy H, Octave-Prignot M, Rombaut P, Scalliet P, et al. Comparison of external radiotherapy, laser microsurgery and partial laryngectomy for the treatment of T1N0M0 glottic carcinomas: a retrospective evaluation. Radiother Oncol 1998;48:175-83.
13. Dey P, Arnold D, Wight R, MacKenzie K, Kelly C, Wilson J. Radiotherapy versus open surgery versus endolaryngeal surgery (with or withoutlaser) for early laryngeal squamous cell cancer. Cochrane Database Syst Rev 2002;2:CD002027.
14. Du G, Liu CH, Yu W, Li J, Li W, Wang CH, et al. Voice outcomes after laser surgery vs. radiotherapy of early glottic carcinoma: a meta-analysis. Int J Clin Exp Med 2015;8:17206-13.
15. Bron LP, Soldati D, Zouhair A, Ozsahin M, Brossard E,Monnier P, et al. Treatment of early stage squamous-cell carcinoma of the glottic larynx: endoscopic surgery or cricohyoidoepiglottopexy versus radiotherapy. Head Neck 2001;23:823-9.
16. Warner L, Chudasama J, Kelly CG, Loughran S, McKenzie K, Wight R, et al. Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early larynx cancer. Cochrane Database Syst Rev 2014;2014:CD002027.
17. Phillips TJ, Sader C, Brown T, Bullock M, Wilke D, Trites JR, et al. Transoral laser microsurgery versus radiation therapy for early glottic cancer in Canada: cost analysis. J Otolaryngol Head Neck Surg 2009;38:619-23.
18. Higgins KM, Shah MD, Ogaick MJ, Enepekides D. Treatment of earlystage glottic cancer: meta-analysis comparison of laser excision versus radiotherapy. J Otolaryngol Head Neck Surg 2009;38:603-12.
19. Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jaconsen G, Benninger MS. The Voice Handicap Index (VHI): Development and Validation. Am J Speech Lang Pathol 1997;6:66-70.
20. Toma M, Nibu KI, Nakao K, Matsuzaki M, Mochiki M, Yuge T, et al. Partial Laryngectomy to Treat Early Glottic Cancer After Failure of Radiation Therapy. Arch Otolaryngol Head Neck Surg 2002;128:909-12.
21. Jacobson BH, Jonson A, Grywalski C. The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 1997;6:66-70.
22. Verdonck–de Leeuw IM, Keus RB, Hilgers FJ, Koopmans-van Beinum FJ, Greven AJ, de Jong JM, et al. Consequences of voice impairment in daily life for patients following radiotherapy for early glottis cancer: voice quality, vocal function, and vocal performance. Int J Radiat Oncol Biol Phys 1999;44:1071-8.
23. Bibby JR, Cotton SM, Perry A, Corry JF. Voice outcomes after radiotherapy treatment for early glottic cancer: assessment using multidimensionaltools. Head Neck 2008;30:600-10.
24. Milovanović JP, Djukić VB, Milovanović AP, Trivić AS, Baljosević IS, Vukasinović MM, et al. What does we need to help laryngectomized speaking? Acta Chir Iugosl 2009;56:95-10.
25. Silver CE, Beitler JJ, Shaha AR, Rinaldo A, Ferlito A. Cur-rent trends in initial management of laryngeal cancer: thedeclining use of open surgery. Eur Arch Otorhinolaryngol 2009;266:1333-52.
26. Back G, Sood S. The management of early laryngeal cancer:options for patients and therapists. Curr Opin Otolaryngol Head Neck Surg 2005;13:85-91.
27. Lefebvre JL. What is the role of primary surgery in the treatmentof laryngeal and hypopharyngeal cancer? Hayes Martin lecture. Arch Otolaryngol Head Neck Surg 2000;126:285-8.
28. Groome PA, Mackillop WJ, Rothwell DM, O’Sullivan B, Irish JC, Hall SF, et al. Management and outcome of glottic cancer:a population-based comparison between Ontario, Canada andthe SEER areas of the United States. J Otolaryngol 2000;29:67-77.
29. Hocevar–Boltezar I, Zargi M, Strojan P. Risk factors for voice quality after radiotherapy for early glottic cancer. Radiother Oncol 2009;93:524–529.
30. Agarwal JP, Baccher GK, Waghmare CM, et al. Factors affecting the quality of voice in the early glottic cancer treated with radiotherapy. Radiother Oncol 2009;90:177–182.
2. Sanderson RJ, Ironside JAD. Squamous cell carcinomas of the head and neck. BMJ 2002;325:822-7.
3. Yasmin B, Bhurgri A, Usman A, Pervez S, Kayani N,BashirI, et al. Epidemiological Review of Head and Neck Cancers in Karachi. Asian Pacific J Cancer Prev 2006;7:195-200.
4. Saedi B, Razmpa E, Sadeghi M, Mojtahed M, Mojtahed A. The epidemiology of laryngeal cancer in a country on the esophageal cancer belt. Indian J Otolaryngol Head Neck Surg 2009;61:213-17.
5. Feng Y, Wang B, Wen S. Laser Surgery versus Radiotherapy for T1–T2N0 Glottic Cancer: A Meta-Analysis. ORL J Otorhinolaryngol Relat Spec 2011;73:336-42.
6. Loon YV, Sjeogren EV, Langeveld TPM, Baatenburg de Jong RJ, Schoones JW, van Rossum MA. Functional outcomes after radiotherapy or laser surgery in early glottic carcinoma: A systematic review. Head Neck 2012;34:1179-89.
7. Toma M, Nibu KI, Nakao K, Matsuzaki M, Mochiki, M Yuge T, et al. Partial Laryngectomy to Treat Early Glottic Cancer After Failure of Radiation Therapy. Arch Otolaryngol Head Neck Surg 2002;128:909-12.
8. Graciano AJ, Sonagli M, Clemente da Silva AG, Fischer CA, Chone CT. Partial laryngectomy in glottic cancer: complications and oncological results. Braz J Otorhinolaryngol 2016;82:275-80.
9. Milovanović JP, Djukić VB, Milovanović AP, Trivić AS, Baljosević IS, Vukasinović MM, et al. Functional results of treatment of early carcinoma in the glottic region of the larynx. Acta Chir Iugosl 2009;56:95-100.
10. Arias F, Arraras JA, Asin G, Uzcanga MI, Marav E, Chicata V, et al. Quality of life and voice assessment in patients with early-stage glottic cancer. Head Neck 2015;37:340-6.
11. Andersen LJ, Evensen J, Mortensen HR, Overgaard J. The DAHANCA 6 randomized trial: Effect of 6 vs 5 weekly fractions of radiotherapy in patients with glottic squamous cell carcinoma. Radiother Oncol 2015;117:91-8.
12. Rosier JF, Grégoire V, Counoy H, Octave-Prignot M, Rombaut P, Scalliet P, et al. Comparison of external radiotherapy, laser microsurgery and partial laryngectomy for the treatment of T1N0M0 glottic carcinomas: a retrospective evaluation. Radiother Oncol 1998;48:175-83.
13. Dey P, Arnold D, Wight R, MacKenzie K, Kelly C, Wilson J. Radiotherapy versus open surgery versus endolaryngeal surgery (with or withoutlaser) for early laryngeal squamous cell cancer. Cochrane Database Syst Rev 2002;2:CD002027.
14. Du G, Liu CH, Yu W, Li J, Li W, Wang CH, et al. Voice outcomes after laser surgery vs. radiotherapy of early glottic carcinoma: a meta-analysis. Int J Clin Exp Med 2015;8:17206-13.
15. Bron LP, Soldati D, Zouhair A, Ozsahin M, Brossard E,Monnier P, et al. Treatment of early stage squamous-cell carcinoma of the glottic larynx: endoscopic surgery or cricohyoidoepiglottopexy versus radiotherapy. Head Neck 2001;23:823-9.
16. Warner L, Chudasama J, Kelly CG, Loughran S, McKenzie K, Wight R, et al. Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early larynx cancer. Cochrane Database Syst Rev 2014;2014:CD002027.
17. Phillips TJ, Sader C, Brown T, Bullock M, Wilke D, Trites JR, et al. Transoral laser microsurgery versus radiation therapy for early glottic cancer in Canada: cost analysis. J Otolaryngol Head Neck Surg 2009;38:619-23.
18. Higgins KM, Shah MD, Ogaick MJ, Enepekides D. Treatment of earlystage glottic cancer: meta-analysis comparison of laser excision versus radiotherapy. J Otolaryngol Head Neck Surg 2009;38:603-12.
19. Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jaconsen G, Benninger MS. The Voice Handicap Index (VHI): Development and Validation. Am J Speech Lang Pathol 1997;6:66-70.
20. Toma M, Nibu KI, Nakao K, Matsuzaki M, Mochiki M, Yuge T, et al. Partial Laryngectomy to Treat Early Glottic Cancer After Failure of Radiation Therapy. Arch Otolaryngol Head Neck Surg 2002;128:909-12.
21. Jacobson BH, Jonson A, Grywalski C. The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 1997;6:66-70.
22. Verdonck–de Leeuw IM, Keus RB, Hilgers FJ, Koopmans-van Beinum FJ, Greven AJ, de Jong JM, et al. Consequences of voice impairment in daily life for patients following radiotherapy for early glottis cancer: voice quality, vocal function, and vocal performance. Int J Radiat Oncol Biol Phys 1999;44:1071-8.
23. Bibby JR, Cotton SM, Perry A, Corry JF. Voice outcomes after radiotherapy treatment for early glottic cancer: assessment using multidimensionaltools. Head Neck 2008;30:600-10.
24. Milovanović JP, Djukić VB, Milovanović AP, Trivić AS, Baljosević IS, Vukasinović MM, et al. What does we need to help laryngectomized speaking? Acta Chir Iugosl 2009;56:95-10.
25. Silver CE, Beitler JJ, Shaha AR, Rinaldo A, Ferlito A. Cur-rent trends in initial management of laryngeal cancer: thedeclining use of open surgery. Eur Arch Otorhinolaryngol 2009;266:1333-52.
26. Back G, Sood S. The management of early laryngeal cancer:options for patients and therapists. Curr Opin Otolaryngol Head Neck Surg 2005;13:85-91.
27. Lefebvre JL. What is the role of primary surgery in the treatmentof laryngeal and hypopharyngeal cancer? Hayes Martin lecture. Arch Otolaryngol Head Neck Surg 2000;126:285-8.
28. Groome PA, Mackillop WJ, Rothwell DM, O’Sullivan B, Irish JC, Hall SF, et al. Management and outcome of glottic cancer:a population-based comparison between Ontario, Canada andthe SEER areas of the United States. J Otolaryngol 2000;29:67-77.
29. Hocevar–Boltezar I, Zargi M, Strojan P. Risk factors for voice quality after radiotherapy for early glottic cancer. Radiother Oncol 2009;93:524–529.
30. Agarwal JP, Baccher GK, Waghmare CM, et al. Factors affecting the quality of voice in the early glottic cancer treated with radiotherapy. Radiother Oncol 2009;90:177–182.
| Files | ||
| Issue | Vol 60, No 2 (2022) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/acta.v60i2.8821 | |
| Keywords | ||
| Partial laryngectomy Radiotherapy Early glottic carcinoma Quality of voice Voice handicap index Complication | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Jafari M, Aghili M, Kamali Hakim E, Sahebi L, Saedi B. Comparison of Partial Laryngectomy Versus Radiotherapy for the Treatment of Early Glottic Carcinoma: Complications and Oncological Results- a Nonrandomized Clinical Trial. Acta Med Iran. 2022;60(2):101-107.
