Risk factors for voice quality after radiotherapy for early glottic cancer

• Published in: Radiotherapy and oncology 2009-12, Vol.93 (3), p.524-529
• Main Authors: Hočevar-Boltežar, Irena, Žargi, Miha, Strojan, Primož
• Format: Article
• Language: English
• Subjects: Acoustic analysis; Adult; Aged; Aged, 80 and over; Glottis; Glottis cancer; Hematology, Oncology and Palliative Medicine; Hoarseness - etiology; Humans; Irradiation; Laryngeal Neoplasms - complications; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - radiotherapy; Male; Middle Aged; Perceptive evaluation; Radiation Injuries; Risk Factors; Smoking; Vocal Cords - pathology; Voice quality; Voice Quality - radiation effects; Young Adult
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2009.09.014

Abstract Background and purpose In the majority of patients irradiated for early glottic cancer an abnormal voice was reported. The purpose of the study was to determine the factors influencing voice quality after radiotherapy for T1 glottic cancer. Methods The voices of 75 male patients irradiated for T1 glottic carcinoma were assessed subjectively and objectively by acoustic analyses and aerodynamic measurements. The laryngeal function and morphology were evaluated by videolaryngostroboscopy. The data on smoking habits, the associated diseases influencing voice quality, the extent of the tumor, the type of biopsy, and the irradiation technique were collected from the medical records. The data on the factors influencing voice quality were compared for patients with a normal/near-normal voice and those with a hoarse voice. Results Voice quality was at least slightly abnormal in 94.7% and 81.3% of patients, when assessed perceptively and objectively, respectively. Smoking after the completed treatment, more severe morphologic alterations of the vocal folds, dryness of the throat, incomplete closure of the vocal folds and functional voice disorders expressed as supraglottic activity adversely influenced the voice quality. A good correlation between the perceptive voice assessment and the acoustic analyses was established. Conclusions After the successful irradiation for T1 glottic carcinoma, the great majority of the patients have at least a slightly hoarse voice. A better voice outcome could be achieved if radiotherapy was followed by the patient’s cessation of smoking and the appropriate voice therapy.