F Xiao1, S Dou2,3,4, Y Li1, W Qian5, F Liang6, L Kong5, X Wang5, K Wu5, C Hu7, G Zhu8,9,10. 1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center Minhang Branch, Shanghai, 200240, China. 2. Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China. 3. National Clinical Research Center for Oral Diseases, Shanghai, 200011, China. 4. Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China. 5. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 200032, People's Republic of China. 6. Department of Statistics, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. 7. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 200032, People's Republic of China. hucsu62@yahoo.com. 8. Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China. antica@gmail.com. 9. National Clinical Research Center for Oral Diseases, Shanghai, 200011, China. antica@gmail.com. 10. Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China. antica@gmail.com.
Abstract
BACKGROUND: Worsening voice and speech quality was frequently reported in head-and-neck patients after radiotherapy to the neck; omitting the lower neck and sparing the glottic larynx in node-negative nasopharyngeal carcinoma (NPC) patients might be safe and feasible, and improve voice and speech outcomes. METHODS: From January 2009 to January 2013, 71 patients were analyzed. All patients received bilateral neck irradiation. Upper group (UG) patients spared the glottic larynx while lower group (LG) patients did not. Voice and speech quality were evaluated at two time-points (T1 and T2) using the Communication Domain of the Head and Neck Quality of Life (HNQOL) instrument and the Speech question of the University of Washington Quality of Life instrument. RESULTS: At a median follow-up time of 32 months (T1),71.6% of patients reported worsened voice and speech quality. UG patients resulted in significant decreases in glottic larynx dose. With a median follow-up time of 71 months (T2), no patients experienced out-of-field nodal recurrence;there was no difference in the 5-year overall survival and nodal recurrence-free survival between two groups (P = 0.235 and 0.750, respectively). At T1, in patients who without concurrent chemotherapy (CCT), UG patients showed significantly better patient-reported voice quality, (P = 0.022). UG patients without CCT also showed higher scores in the HNQOL communication domain and pain domain (P = 0.012 and P = 0.019). CONCLUSIONS: For node-negative NPC patients, omitting the lower neck and sparing the glottic larynx was safe and feasible, and better voice outcomes were achieved in patients without CCT. Further prospective longitudinal studies to investigate whether this approach would be beneficial to node-negative patients are warranted.
BACKGROUND: Worsening voice and speech quality was frequently reported in head-and-neck patients after radiotherapy to the neck; omitting the lower neck and sparing the glottic larynx in node-negative nasopharyngeal carcinoma (NPC) patients might be safe and feasible, and improve voice and speech outcomes. METHODS: From January 2009 to January 2013, 71 patients were analyzed. All patients received bilateral neck irradiation. Upper group (UG) patients spared the glottic larynx while lower group (LG) patients did not. Voice and speech quality were evaluated at two time-points (T1 and T2) using the Communication Domain of the Head and Neck Quality of Life (HNQOL) instrument and the Speech question of the University of Washington Quality of Life instrument. RESULTS: At a median follow-up time of 32 months (T1),71.6% of patients reported worsened voice and speech quality. UG patients resulted in significant decreases in glottic larynx dose. With a median follow-up time of 71 months (T2), no patients experienced out-of-field nodal recurrence;there was no difference in the 5-year overall survival and nodal recurrence-free survival between two groups (P = 0.235 and 0.750, respectively). At T1, in patients who without concurrent chemotherapy (CCT), UG patients showed significantly better patient-reported voice quality, (P = 0.022). UG patients without CCT also showed higher scores in the HNQOL communication domain and pain domain (P = 0.012 and P = 0.019). CONCLUSIONS: For node-negative NPCpatients, omitting the lower neck and sparing the glottic larynx was safe and feasible, and better voice outcomes were achieved in patients without CCT. Further prospective longitudinal studies to investigate whether this approach would be beneficial to node-negative patients are warranted.
Authors: Vinidh Paleri; Paul Carding; Sanjoy Chatterjee; Charles Kelly; Janet Ann Wilson; Andrew Welch; Michael Drinnan Journal: Head Neck Date: 2012-02-09 Impact factor: 3.147
Authors: Nam P Nguyen; Dave Abraham; Anand Desai; Michael Betz; Rick Davis; Thomas Sroka; Alexander Chi; Steven Gelumbauskas; Misty Ceizyk; Lexie Smith-Raymond; Michelle Stevie; Siyoung Jang; Russ Hamilton; Vincent Vinh-Hung Journal: Oral Oncol Date: 2011-07-02 Impact factor: 5.337
Authors: Lisette van der Molen; Maya A van Rossum; Irene Jacobi; Rob J J H van Son; Ludi E Smeele; Coen R N Rasch; Frans J M Hilgers Journal: J Voice Date: 2011-12-29 Impact factor: 2.009
Authors: Irene Jacobi; Lisette van der Molen; Hermelinde Huiskens; Maya A van Rossum; Frans J M Hilgers Journal: Eur Arch Otorhinolaryngol Date: 2010-06-30 Impact factor: 2.503