title: Functional outcomes after radiotherapy or laser surgery in early glottic carcinoma: a systematic review.
abstract: BACKGROUND
  Early glottic carcinoma is treated with laser surgery or radiotherapy, but which treatment has better functional outcomes is unclear. This systematic review compared functional outcomes (voice, swallowing, quality of life [QOL]) in more extended T1a and limited T2 tumors (1) between treatments and (2) between greater and lesser laser resections.
  
  
  METHODS
  A systematic literature search covered relevant databases from 1990 to 2009, combining all patient/problem, intervention, comparison, outcome (PICO) keyword variations.
  
  
  RESULTS
  A total of 19 papers met the inclusion criteria, all of which were level IV evidence. Papers reported only voice and QOL. Heterogeneity of outcome measures prevented data pooling. Uncertainty about tumor comparability (depth, extent) between the 2 treatments, small subject numbers, and poor-quality reporting hindered interpretation.
  
  
  CONCLUSIONS
  To allow comparison of laser surgery versus radiotherapy, a standardized method is needed that accurately measures tumor extent and depth. Agreement on functional outcome measures is necessary to allow comparison of treatments and resection types. Multicenter studies should be encouraged to guarantee adequate subject numbers.
authors.affiliation: Department of ENT-Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands. y.van_loon@lumc.nl
authors.forename: Yda
authors.initials: Y
authors.lastname: van Loon
authors.forename: Elisabeth V
authors.initials: EV
authors.lastname: Sjögren
authors.forename: Ton P M
authors.initials: TP
authors.lastname: Langeveld
authors.forename: Rob J
authors.initials: RJ
authors.lastname: Baatenburg de Jong
authors.forename: Jan W
authors.initials: JW
authors.lastname: Schoones
authors.forename: Maya A
authors.initials: MA
authors.lastname: van Rossum
mesh_terms: D002277:Carcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003679:Deglutition; D005931:Glottis / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D053685:Laser Therapy; D011788:Quality of Life; D049489:Stroboscopy; D014833:Voice Quality