Voice Quality After Treatment of T1a Glottic Cancer

Objectives/hypothesis: To compare voice handicap and quality of life after radiotherapy (RT) versus transoral laser surgery (LS) for T1a glottic carcinoma.

Study Design: Retrospective study (1996-2011) of patients treated with RT or LS for T1a glottic squamous cell carcinoma with curative intent.

Methods: Disease-free patients were assessed using Voice Handicap Index (VHI 30) and European Organization for Research and Treatment of Cancer Head and Neck Quality of Life (EORTC QLQ-HN35) questionnaires.

Results: Of 147 patients, 95 (65%) completed the questionnaires: fifty-one patients an average of 8 years after RT and 44 patients an average of 4 years after LS (no difference in age or sex ratio). The average total VHI 30 was 13.1 for RT and 29.2 for LS (P < .0001), with average emotional, physical and functional subscores significantly different. The average total EORTC QLQ-HN35 was 37.7 for RT versus 40.7 for LS (P = .7), with a difference only in the speaking subscore (P = .04).

Conclusions: Long-term subjective voice-related quality of life was worse after LS, with no difference in other domains. These results should be interpreted in light of the biases inherent in retrospective studies.

Level Of Evidence: 4.