Organ function and quality of life after transoral laser microsurgery and adjuvant radiotherapy for locally advanced laryngeal cancer.
OBJECTIVE
Transoral laser microsurgery (TLM) and adjuvant radiotherapy are an established therapy regimen for locally advanced laryngeal cancer at our institution. Aim of the present study was to assess value of quality of life (QoL) data with special regard to organ function under consideration of treatment efficacy in patients with locally advanced laryngeal cancer treated with larynx-preserving TLM and adjuvant radiotherapy.


METHODS
From 1994 to 2006, 39 patients (ten UICC stage III, 29 UICC stage IVA/B) with locally advanced laryngeal carcinomas were treated with TLM and adjuvant radiotherapy. Data concerning treatment efficacy, QoL (using the VHI [Voice Handicap Index], the EORTC QLQ-C30 and QLQ-H&N35 questionnaires) and organ function (respiration, deglutition, voice quality) were obtained for ten patients still alive after long-term follow-up. Correlations were determined using the Spearman rank test.


RESULTS
After a median follow-up of 80.8 months, the 5-year overall survival rate was 46.8% and the locoregional control rate 76.5%, respectively. The larynx preservation rate was 89.7% for all patients and 100% for patients still alive after follow-up. Despite some verifiable problems in respiration, speech and swallowing, patients showed a subjectively good QoL.


CONCLUSIONS
TLM and adjuvant radiotherapy is a curative option for patients with locally advanced laryngeal cancer and an alternative to radical surgery. Even if functional deficits are unavoidable in the treatment of locally advanced laryngeal carcinomas, larynx preservation is associated with a subjectively good QoL.
Department of Phoniatrics and Pedaudiology, University of Göttingen, Göttingen, Germany.
Arno
A
Olthoff
Andreas
A
Ewen
Hendrik Andreas
HA
Wolff
Robert Michael
RM
Hermann
Hilke
H
Vorwerk
Andrea
A
Hille
Ralph
R
Rödel
Clemens F
CF
Hess
Wolfgang
W
Steiner
Olivier
O
Pradier
Hans
H
Christiansen
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000379:methods; D020266:Radiotherapy, Conformal / Q000379:methods*; D020127:Recovery of Function; D016896:Treatment Outcome