Patients with locally advanced laryngopharyngeal cancers who receive radical chemoradiation have significantly better voice outcomes during the 12 months following treatment when compared with patients who have undergone a total laryngectomy and surgical voice restoration, according to a study in the February 1 issue of the International Journal for Radiation Oncology-Biology-Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.
The conventional treatment for patients with advanced squamous carcinoma of the larynx has traditionally been a total laryngectomy, which is the removal of the voice box, with or without radiation; however, this treatment has several serious side effects, including natural-voice loss, altered food-swallowing function and a permanent opening in the trachea.
Researchers in this study, conducted jointly by the Royal Marsden Hospital Head and Neck Unit and The Institute of Cancer Research, both in London, sought to determine if larynx preservation through chemoradiation would result in improved voice results and serve as a suitable alternative to total laryngectomy, which, in turn, would remove the need for surgery and all of the related potential side effects and risks.
Twenty-one patients, both male and female, with a median age of 65 years old, who were diagnosed with Stage III or IV laryngopharyngeal cancer, were given induction chemotherapy followed by radical chemoradiation. The researchers then used electroglottography – placing electrodes alongside the larynx – to electronically record and analyze the voice function of the patients before treatment and at one, six and 12 months after treatment. This is the first study of its kind to use electroglottography as an assessment technique.
Patients were asked to read a standard passage and pronounce vowel sounds into a microphone that sat at the same distance from the mouth of each patient. The researchers then used these recordings to measure jitter in the voice, maximum phonation time and words per minute.