Voice and Swallowing Outcomes After Early Laryngeal Cancer: A UK Based Multi-Centre Study

Area of Science:

• Otolaryngology
• Oncology
• Speech and Language Therapy

Background:

• Early laryngeal cancer treatment options include transoral laser microsurgery (TLM) and radiotherapy, with similar oncological results.
• The comparative impact of TLM versus radiotherapy on voice and swallowing function is not well-established.

Purpose of the Study:

• To prospectively evaluate and compare voice and swallowing outcomes in patients with early laryngeal cancer treated with TLM or radiotherapy.
• To assess functional recovery using a standardized multidimensional protocol in a UK multi-centre setting.

Main Methods:

• 137 patients with T1/T2 laryngeal cancer were enrolled across five UK centers.
• Treatments administered were TLM or radiotherapy (up to 55 Gy).
• Voice (VHI-10, MPT, GRBAS) and swallowing (100mL water test, NoD) were assessed at baseline, 3, and 6 months post-treatment.

Main Results:

• Radiotherapy showed significant improvements in Voice Handicap Index scores and maximum phonation time at 3 months.
• Reduced hoarseness was observed post-radiotherapy compared to TLM at 3 months.
• No significant differences in swallowing function or Normalcy of Diet were found between the treatment groups up to 6 months.

Conclusions:

• Radiotherapy demonstrates superior short-term voice outcomes compared to TLM for early laryngeal cancer.
• Swallowing function appears largely independent of the treatment modality chosen.
• Functional outcomes should be integral to treatment decisions for early laryngeal cancer.