The impact of radiotherapy on swallowing and speech in patients who undergo total laryngectomy.
OBJECTIVE
Quality of life studies have shown no detrimental effect with radiotherapy (RT) in patients who have a total laryngectomy. We wished to determine the effect of RT (initial or postoperative) specifically on the swallowing and voice function in patients treated by total laryngectomy (TL) for carcinoma of the larynx.


METHODS
Multicenter chart review.


METHODS
Multicenter study in the Greater Manchester and Lancashire area.


METHODS
A total of 121 postlaryngectomy patients all of whom had completed definitive treatment at least 6 months before this study. Twenty-six patients had total laryngectomy as a single modality treatment and 95 had total laryngectomy and radiotherapy.


METHODS
Swallowing (solid food, soft diet or fluid/PEG) and voice development.


RESULTS
Swallowing was better in the group who had no radiotherapy (P = 0.0037). There was no difference in voice function between the two groups. We also demonstrated that females had a worse swallowing outcome (P = 0.0101), as did advanced nodal stage (P = 0.001).


CONCLUSIONS
RT adversely affects the swallowing results but not the speech results after TL when given either as initial treatment or postoperatively. This should be kept in mind in the decision-making process in the treatment of patients with carcinoma of the larynx.
de Casso
Carmen
C
University Department of Otolaryngology-Head and Neck Surgery, Manchester Royal Infirmary, Manchester, UK. cdecasso@doctors.org.uk
Slevin
Nicholas J
NJ
Homer
Jarrod J
JJ
D000367:Age Factors; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects* / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011879:Radiotherapy Dosage; D012737:Sex Factors; D016896:Treatment Outcome; D014832:Voice Disorders / Q000209:etiology* / Q000503:physiopathology