Summary
Objectives
Radiation treatment for laryngeal cancer has been shown to cause tissue changes to
the vocal folds, which can result in degradation of voice. Our objective in this study
was to investigate changes in perceptual, acoustic, and patient-reported outcomes
over an extended period of follow-up after radiation.
Design
Retrospective review.
Methods
All patients treated with radiation for early-stage laryngeal carcinoma (in situ, T1, or T2) by a single surgeon from 2011–2018 were reviewed. Demographics and treatment
information were recorded. Only patients with at least two dates of follow-up with
acoustic data (cepstral spectral index of dysphonia [CSID]) and patient-reported surveys
(voice handicap index-10 [VHI-10]) were included. Voice samples were rated by two
senior speech-language pathologists on the grade, roughness, breathiness, asthenia,
and strain scale.
Results
Of 115 patients with early-stage laryngeal cancer, 31 patients met inclusion criteria.
The average follow-up from time of treatment was 9.6 years (range 3.0–20.3 years),
and the average time in between the first and last voice recordings was 2.6 years
(range 0.3–5.5 years). The lesions represented were carcinoma in situ (n = 4), T1 (n = 22), and T2 (n = 5). The VHI-10 scores worsened slightly (mean increase +0.27, median +1) from first
to last measurements as did the CSID score (median increase +7.0, median +7.4), though
neither reached statistical significance when correlated with time since radiation
(P = 0.269 and P = 0.0850). Perceptual analysis as rated by two speech-language pathologists raters
showed excellent inter-rater reliability (Cronbach's alpha = 0.84), with no significant
change over time (mean +0.39, median, with P = 0.347). Grade, roughness, breathiness, asthenia, and strain, VHI-10, and CSID were
all correlated (all pairwise comparisons P < 0.001).
Conclusion
Perceptual, acoustic, and patient-reported outcomes years after radiation for early-stage
laryngeal cancer do not show voice degradation over time in this preliminary analysis.
Further research with a larger cohort may elucidate voice changes in this population.
Key Words
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Article info
Publication history
Published online: January 02, 2019
Accepted:
November 14,
2018
Footnotes
Presentation information: Podium presentation at 2018 Fall Voice Meeting, Seattle, Washington, United States.
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
