Change in Voice Quality after Radiotherapy for Early Glottic Cancer

Our aim was to track the changes in voice quality for two years after radiotherapy (RT) for early glottic cancer. A videoendostroboscopy, subjective patient and phoniatrician voice assessments, a Voice Handicap Index questionnaire, and objective acoustic measurements (F0, jitter, shimmer, maximal phonation time) were performed on 50 patients with T1 glottic carcinomas at 3, 12, and 24 months post-RT. The results were compared between the subsequent assessments, and between the assessments at 3 months and 24 months post-RT. The stroboscopy showed a gradual progression of fibrosis of the vocal folds with a significant difference apparent when the assessments at 3 months and 24 months were compared (p < 0.001). Almost all of the subjective assessments of voice quality showed an improvement during the first 2 years, but significant differences were noted at 24 months. Jitter and shimmer deteriorated in the first year after RT with a significant deterioration noticed between the sixth and twelfth months (p = 0.048 and p = 0.002, respectively). Two years after RT, only 8/50 (16%) patients had normal voices. The main reasons for a decreased voice quality after RT for early glottic cancer were post-RT changes in the larynx. Despite a significant improvement in the voice after RT shown in a few of the evaluation methods, only a minority of the patients had a normal voice two years post-RT.