Factors affecting voice quality in early glottic cancer before and after radiotherapy
Article Category: Research Article
Publicado en línea: 18 oct 2019
Páginas: 459 - 464
Recibido: 25 ago 2019
Aceptado: 17 sept 2019
DOI: https://doi.org/10.2478/raon-2019-0050
© 2019 Jana Mekis, Primoz Strojan, Irena Hocevar Boltezar, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Radiotherapy (RT) is a successful mode of treatment for early glottic cancer. The aim of the study was to assess voice quality both before and 3 months after successful RT using multimodal methods while also identifying the factors affecting it.
Patients and methods
In 50 patients with T1 glottic carcinoma, the subjective (patients’ assessment of voice quality [VAS], Voice Handicap Index [VHI] questionnaire, phoniatricians’ assessment using the grade/roughness/ breathiness [GRB] scale), and objective assessments (fundamental laryngeal frequency [F0], jitter, shimmer, maximum phonation time [MPT]) of voice quality were performed before RT and 3 months post-RT. The data on gender, age, extent of the tumors, biopsy types, smoking, local findings, and RT were obtained from the medical documentation.
Results
Three months after the treatment, VAS, VHI, G and R scores, F0, and MPT significantly improved in comparison with their assessment prior to treatment. Before the treatment, the involvement of the anterior commissure significantly deteriorated jitter (p = 0.044) and the involvement of both vocal folds deteriorated jitter (p = 0.003) and shimmer (p = 0.007). After the RT, F0 was significantly higher in the patients with repeated biopsy than in the others (p = 0.047). In patients with post-RT changes, the B score was significantly higher than in those without post-RT changes (p = 0.029).
Conclusions
Voice quality already significantly improved three months after the treatment of glottic cancer. The main reason for the decreased voice quality prior to treatment is the tumor’s extent. Post-RT laryngeal changes and repeated biopsies caused more scarring on vocal folds adversely influencing voice quality after the treatment.