Voice quality after laser surgery

Grant Details

Grantee Name: Dr. Elicin Olgun
Organization: Bern University Hospital
Country: Switzerland

Project Name: Voice quality after laser surgery versus single vocal cord irradiation
Funding Year: 2019
Project period: 5 years

Voice quality after laser surgery versus single vocal cord irradiation

This proposal seeks to compare single vocal cord irradiation (SVCI) to transoral CO2-laser microsurgical cordectomy (TLM) on patient-reported voice quality in a prospective randomized multi-center open-label comparative phase III study.  This approach is promising to spare voice quality and thus improve quality of life.

Lay Abstract

Laser surgery and radiotherapy are well-established standards of care for unilateral stage 0 & I carcinoma in situ (Cais) and squamous cell carcinoma of glottic larynx (SCCGL). Based on meta-analyses, functional and oncological outcome after both treatment modalities are comparable. However, no properly conducted randomized trials comparing these treatments exist. The only such trial with the endpoint of voice quality had to be prematurely closed due to low accrual.
The traditional radiotherapy involves the treatment of the whole larynx. Recently, a new radiotherapy technique was introduced by a team of researchers from Netherlands, where the treated target volume consists of involved vocal cord and therefore 8 to 10-fold smaller than the target volumes used for traditional whole larynx irradiation. The treatment is reduced to 16 fractions which corresponds to 3 weeks and a day. The results of a prospective cohort (n=30) with single vocal cord irradiation (SVCI) were compared with the results of a historical prospective cohort previously treated with whole larynx radiotherapy (n=131) in the same institute. The median follow-up was 30 months. The voice handicap index (VHI) at all time points beginning from the 6th week after SVCI was significantly superior to the same time points with conventional radiotherapy. Moreover, a comparable local control with SVCI (100%) vs. conventional radiotherapy (92%) was reported at two years, p=0.2412.
Based on this information, the investigators' main aim is to compare SVCI to Transoral CO2-Laser Microsurgical Cordectomy (TLM) with the main focus of patient-reported voice quality.

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