Multidisciplinary Approach in the Treatment of T1 Glottic Cancer. The Role of Patient Preference in a Homogenous Patient Population

Overview

Journal Strahlenther Onkol

Specialties Oncology
Radiology

Date 2010 Nov 12

PMID 21069268

Citations 27

Authors

Nicola Dinapoli

Claudio Parrilla

Jacopo Galli

Rosa Autorino

Francesco Micciche

Francesco Bussu

Mario Balducci

Lucia DAlatri

Raffaella Marchese

Mario Rigante

Giuseppe Di Lella

Luca Liberati

Giovanni Almadori

Gaetano Paludetti

Vincenzo Valentini

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: To compare oncological outcome and voice quality among a uniform and well-defined subset of patients with T1 glottic carcinoma.

Patients And Methods: Patients, affected by laryngeal glottic carcinoma, treated by laser CO2 surgery or radiotherapy, have been analyzed. Overall survival and disease-free survival were calculated. In order to verify differences in functional outcomes and voice quality, all patients were interviewed during their last follow-up visit during 2009 using the VHI (Voice Handicap Index) questionnaire. The data were analyzed using the MedCalc software.

Results: A total of 143 patients were analyzed: 73 underwent surgery and 70 underwent radiotherapy. No statistically significant differences were found between the two groups in terms of overall survival and disease-free survival; dividing patients into stages T1a and T1b also made no difference. In order to evaluate the differences in outcomes for surgery and radiotherapy, patients were interviewed using the VHI questionnaire. Better scores for each category in the VHI were found for patients receiving radiotherapy compared to surgery (physical: p = 0.0023; functional: p < 0.0001; environmental: p < 0.001). The median VHI score for radiotherapy patients was 4, while for surgical patients it was 18 (p < 0.0001).

Conclusion: This study confirms the well-known knowledge that results from radiotherapy and surgery in early glottic cancer treatment are equivalent. Furthermore, the role of patient preference in the treatment modality choice and the value of a multidisciplinary approach for a detailed and multi-oriented discussion with the patient are outlined.

Citing Articles

Influence of age on voice quality after transoral CO laser microsurgery.

Lechien J, Hans S, Crevier-Buchman L J Otolaryngol Head Neck Surg. 2023; 52(1):59.

PMID: 37697412 PMC: 10496204. DOI: 10.1186/s40463-023-00664-3.

Evaluation of Voice After Definitive Radiotherapy in Patients of Early Stage Squamous Cell Carcinoma of Larynx (Glottis): A Prospective Observational Study.

Mishra A, Sinha V, Suhag V, Nilakantan A Indian J Otolaryngol Head Neck Surg. 2022; 74(Suppl 2):2386-2394.

PMID: 36452620 PMC: 9701973. DOI: 10.1007/s12070-020-02193-1.

VoiceS: voice quality after transoral CO laser surgery versus single vocal cord irradiation for unilateral stage 0 and I glottic larynx cancer-a randomized phase III trial.

Reinhardt P, Giger R, Seifert E, Shelan M, Riggenbach E, Terribilini D Trials. 2022; 23(1):906.

PMID: 36303192 PMC: 9615245. DOI: 10.1186/s13063-022-06841-5.

Reliability of a Multidisciplinary Multiparametric Approach in the Surgical Planning of Laryngeal Squamous Cell Carcinomas: A Retrospective Observational Study.

Rizzo D, Crescio C, Tramaloni P, De Luca L, Turra N, Manca A J Pers Med. 2022; 12(10).

PMID: 36294725 PMC: 9605535. DOI: 10.3390/jpm12101585.

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

Trignani M, Di Pilla A, Rosa C, Borgia M, Fasciolo D, Gasparini L Cancer Diagn Progn. 2022; 1(3):143-149.

PMID: 35399320 PMC: 8962787. DOI: 10.21873/cdp.10019.

References

Smee R, Bridger G, Williams J, Fisher R . Early glottic carcinoma: results of treatment by radiotherapy. Australas Radiol. 2000; 44(1):53-9. DOI: 10.1046/j.1440-1673.2000.00772.x. View

Testa D, Galli V, De Rosa G, Iovine R, Staibano S, Somma P . Clinical and prognostic aspects of laryngeal clear cell carcinoma. J Laryngol Otol. 2005; 119(12):991-4. DOI: 10.1258/002221505775010715. View

Gallo A, de Vincentiis M, Manciocco V, Simonelli M, Fiorella M, Shah J . CO2 laser cordectomy for early-stage glottic carcinoma: a long-term follow-up of 156 cases. Laryngoscope. 2002; 112(2):370-4. DOI: 10.1097/00005537-200202000-00030. View

LINDHOLM C, Elner A . Transoral laser surgery of laryngeal carcinomas. State of the art in Sweden. Adv Otorhinolaryngol. 1995; 49:250-3. DOI: 10.1159/000424384. View

Fung K, Yoo J, Leeper H, Hawkins S, Heeneman H, Doyle P . Vocal function following radiation for non-laryngeal versus laryngeal tumors of the head and neck. Laryngoscope. 2002; 111(11 Pt 1):1920-4. DOI: 10.1097/00005537-200111000-00009. View

Almadori G, Ottaviani F, DAlatri L, Carriero E, MODICA V, Paludetti G . [Functional results after cordectomy in laryngeal fissure and in microlaryngoscopy with CO2 laser]. Acta Otorhinolaryngol Ital. 1998; 18(1):16-22. View

Sjogren E, Snijder S, van Beekum J, Baatenburg de Jong R . Second malignant neoplasia in early (TIS-T1) glottic carcinoma. Head Neck. 2006; 28(6):501-7. DOI: 10.1002/hed.20453. View

Sjogren E, Wiggenraad R, le Cessie S, Snijder S, Pomp J, Baatenburg de Jong R . Outcome of radiotherapy in T1 glottic carcinoma: a population-based study. Eur Arch Otorhinolaryngol. 2008; 266(5):735-44. DOI: 10.1007/s00405-008-0803-9. View

Steiner W . Results of curative laser microsurgery of laryngeal carcinomas. Am J Otolaryngol. 1993; 14(2):116-21. DOI: 10.1016/0196-0709(93)90050-h. View

10.

Sankaranarayanan R, Masuyer E, Swaminathan R, Ferlay J, Whelan S . Head and neck cancer: a global perspective on epidemiology and prognosis. Anticancer Res. 1999; 18(6B):4779-86. View

11.

Chatani M, Matayoshi Y, Masaki N, Teshima T, Inoue T . Radiation therapy for early glottic carcinoma (T1N0M0). The adverse effect of treatment interruption. Strahlenther Onkol. 1997; 173(10):502-6. DOI: 10.1007/BF03038465. View

12.

Tiwari R, Mahieu H . Surgical management of acquired laryngopharyngeal fistulae. Eur Arch Otorhinolaryngol. 1999; 256(7):361-5. DOI: 10.1007/s004050050164. View

13.

Olthoff A, Ewen A, Wolff H, Hermann R, Vorwerk H, Hille A . Organ function and quality of life after transoral laser microsurgery and adjuvant radiotherapy for locally advanced laryngeal cancer. Strahlenther Onkol. 2009; 185(5):303-9. DOI: 10.1007/s00066-009-1967-y. View

14.

Reddy S, Mohideen N, Marra S, Marks J . Effect of tumor bulk on local control and survival of patients with T1 glottic cancer. Radiother Oncol. 1998; 47(2):161-6. DOI: 10.1016/s0167-8140(97)00196-5. View

15.

Leeper K, Stegall M, Stegall M . Basic aseptic technique for medical students: Identifying essential entry-level competencies. Curr Surg. 2005; 59(1):69-73. DOI: 10.1016/s0149-7944(01)00494-9. View

16.

Wedman J, Heimdal J, Elstad I, Olofsson J . Voice results in patients with T1a glottic cancer treated by radiotherapy or endoscopic measures. Eur Arch Otorhinolaryngol. 2002; 259(10):547-50. DOI: 10.1007/s00405-002-0478-6. View

17.

Goor K, Peeters A, Mahieu H, Langendijk J, Leemans C, Verdonck-de Leeuw I . Cordectomy by CO2 laser or radiotherapy for small T1a glottic carcinomas: costs, local control, survival, quality of life, and voice quality. Head Neck. 2006; 29(2):128-36. DOI: 10.1002/hed.20500. View

18.

Sakata K, Someya M, Hori M, Nakata K, Takagi M, Hareyama M . Hyperfractionated accelerated radiotherapy for T1,2 glottic carcinoma. Consideration of time-dose factors. Strahlenther Onkol. 2008; 184(7):364-9. DOI: 10.1007/s00066-008-1819-1. View

19.

Yu E, Shenouda G, Beaudet M, Black M . Impact of radiation therapy fraction size on local control of early glottic carcinoma. Int J Radiat Oncol Biol Phys. 1997; 37(3):587-91. DOI: 10.1016/s0360-3016(96)00578-0. View

20.

Peeters A, van Gogh C, Goor K, Verdonck-de Leeuw I, Langendijk J, Mahieu H . Health status and voice outcome after treatment for T1a glottic carcinoma. Eur Arch Otorhinolaryngol. 2004; 261(10):534-40. DOI: 10.1007/s00405-003-0697-5. View