Prospective, longitudinal electroglottographic study of voice recovery following accelerated hypofractionated radiotherapy for T1/T2 larynx cancer.
OBJECTIVE
To measure voice outcomes following accelerated hypofractionated radiotherapy for larynx cancer.


METHODS
Twenty-five patients with T1/T2 glottic cancer underwent serial electroglottographic and acoustic analysis (sustained vowel/i/ and connected speech) before radiotherapy and 1, 6 and 12 months post-treatment. Twenty-five normal subjects served as a reference control population.


RESULTS
Pre-treatment measures were significantly worse for larynx cancer patients. Median jitter (0.23% vs 0.97%, p=0.001) and shimmer (0.62dB vs 0.98dB, p=0.05) and differences in data ranges reflected greater frequency and amplitude perturbation in the larynx cancer patients. Pre-treatment Mean Phonation Time (MPT) was significantly reduced (21s vs 14.8s, p=0.002) in larynx cancer patients. There was a trend towards improvement of jitter, shimmer and normalized noise energy at 12 months post-treatment. MPT improved but remained significantly worse than for normal subjects (21s vs 16.4s, p=0.013). Average fundamental frequency resembled normal subjects, including improvement of the measured range (91.4-244.6Hz in controls vs 100-201Hz in post-treatment larynx cancer patients).


CONCLUSIONS
This non-invasive technique effectively measures post-treatment vocal function in larynx cancer patients. This study demonstrated improvement of many key parameters that influence voice function over 12 months after radiotherapy.
Kazi
Rehan
R
Head and Neck Unit, Royal Marsden Hospital, London, UK.
Venkitaraman
Ramachandran
R
Johnson
Catherine
C
Prasad
Vyas
V
Clarke
Peter
P
Newbold
Kate
K
Rhys-Evans
Peter
P
Nutting
Christopher
C
Harrington
Kevin
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D019583:Dose Fractionation, Radiation; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D014833:Voice Quality / Q000528:radiation effects*