Postradiotherapy Voice Outcomes in Early-Stage Laryngeal Cancer: A Systematic Review

Laryngeal cancer is one of the most common malignancies of the head and neck with dysphonia. While dysphonia is a frequent sequela post-radiation therapy (RT) for early-stage laryngeal cancer (ESLC), prior work has largely focused on chronic posttreatment outcomes. We hypothesize that acute and subacute dysphonia, as evidenced by a multidimensional voice assessment, will also be present in a subgroup of these patients. The aim of this systematic review was to summarize characteristics of vocal function post-RT for persons with ESLC in order to recognize how voice outcomes present across acute, subacute, and chronic phases of post-RT.

A literature search was conducted using three electronic databases: PubMed, Embase, and CINAHL. A similar strategy was used in all three databases to highlight the concepts of "laryngeal neoplasm," "radiotherapy," and "voice disorders" guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards. Studies evaluated were subgrouped based on temporal relationships from radiotherapy-acute, subacute, and chronic-and analyzed accordingly.

Forty-eight articles, comprising data from 1,747 patients, met inclusion criteria that reported voice outcomes results in patients with ESLC disease that underwent RT. As hypothesized, dysphonia was present not only in the chronic phase but also acutely and subacutely in a subgroup of patients across all domains of voice evaluations, except self-assessment.

Across all post-RT phases, a subset of patients demonstrates early dysphonia, highlighting the value of early voice surveillance to promote access to intervention prior to late-onset radiation-induced dysphonia. This evidence suggests a need for routine voice screenings in this population and, when indicated, timely referral to a speech-language pathologist for a multidimensional voice evaluation and intervention.

https://doi.org/10.23641/asha.34735284.