S A C Kraaijenga1, I M Oskam1, R J J H van Son2, O Hamming-Vrieze3, F J M Hilgers4, M W M van den Brekel5, L van der Molen1. 1. The Netherlands Cancer Institute, Department of Head and Neck Oncology and Surgery, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. 2. The Netherlands Cancer Institute, Department of Head and Neck Oncology and Surgery, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; Institute of Phonetic Sciences, University of Amsterdam, Spuistraat 210, 1012 VT Amsterdam, The Netherlands. 3. The Netherlands Cancer Institute, Department of Radiation Oncology, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. 4. The Netherlands Cancer Institute, Department of Head and Neck Oncology and Surgery, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; Institute of Phonetic Sciences, University of Amsterdam, Spuistraat 210, 1012 VT Amsterdam, The Netherlands. Electronic address: f.hilgers@nki.nl. 5. The Netherlands Cancer Institute, Department of Head and Neck Oncology and Surgery, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; Institute of Phonetic Sciences, University of Amsterdam, Spuistraat 210, 1012 VT Amsterdam, The Netherlands; Academic Medical Center, Department of Oral and Maxillofacial Surgery, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
Abstract
OBJECTIVES: Assessment of long-term objective and subjective voice, speech, articulation, and quality of life in patients with head and neck cancer (HNC) treated with concurrent chemoradiotherapy (CRT) for advanced, stage IV disease. MATERIALS AND METHODS: Twenty-two disease-free survivors, treated with cisplatin-based CRT for inoperable HNC (1999-2004), were evaluated at 10-years post-treatment. A standard Dutch text was recorded. Perceptual analysis of voice, speech, and articulation was conducted by two expert listeners (SLPs). Also an experimental expert system based on automatic speech recognition was used. Patients' perception of voice and speech and related quality of life was assessed with the Voice Handicap Index (VHI) and Speech Handicap Index (SHI) questionnaires. RESULTS: At a median follow-up of 11-years, perceptual evaluation showed abnormal scores in up to 64% of cases, depending on the outcome parameter analyzed. Automatic assessment of voice and speech parameters correlated moderate to strong with perceptual outcome scores. Patient-reported problems with voice (VHI>15) and speech (SHI>6) in daily life were present in 68% and 77% of patients, respectively. Patients treated with IMRT showed significantly less impairment compared to those treated with conventional radiotherapy. CONCLUSION: More than 10-years after organ-preservation treatment, voice and speech problems are common in this patient cohort, as assessed with perceptual evaluation, automatic speech recognition, and with validated structured questionnaires. There were fewer complaints in patients treated with IMRT than with conventional radiotherapy.
OBJECTIVES: Assessment of long-term objective and subjective voice, speech, articulation, and quality of life in patients with head and neck cancer (HNC) treated with concurrent chemoradiotherapy (CRT) for advanced, stage IV disease. MATERIALS AND METHODS: Twenty-two disease-free survivors, treated with cisplatin-based CRT for inoperable HNC (1999-2004), were evaluated at 10-years post-treatment. A standard Dutch text was recorded. Perceptual analysis of voice, speech, and articulation was conducted by two expert listeners (SLPs). Also an experimental expert system based on automatic speech recognition was used. Patients' perception of voice and speech and related quality of life was assessed with the Voice Handicap Index (VHI) and Speech Handicap Index (SHI) questionnaires. RESULTS: At a median follow-up of 11-years, perceptual evaluation showed abnormal scores in up to 64% of cases, depending on the outcome parameter analyzed. Automatic assessment of voice and speech parameters correlated moderate to strong with perceptual outcome scores. Patient-reported problems with voice (VHI>15) and speech (SHI>6) in daily life were present in 68% and 77% of patients, respectively. Patients treated with IMRT showed significantly less impairment compared to those treated with conventional radiotherapy. CONCLUSION: More than 10-years after organ-preservation treatment, voice and speech problems are common in this patient cohort, as assessed with perceptual evaluation, automatic speech recognition, and with validated structured questionnaires. There were fewer complaints in patients treated with IMRT than with conventional radiotherapy.
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