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Meta-Analysis
. 2018 Aug 9;8(1):11900.
doi: 10.1038/s41598-018-30218-x.

Comparison between transoral laser surgery and radiotherapy in the treatment of early glottic cancer: A systematic review and meta-analysis

André Vicente Guimarães  1   2 , Rogério Aparecido Dedivitis  3 , Leandro Luongo Matos  3 , Felipe Toyama Aires  3 , Claudio Roberto Cernea  4
Affiliations
Meta-Analysis

Comparison between transoral laser surgery and radiotherapy in the treatment of early glottic cancer: A systematic review and meta-analysis

André Vicente Guimarães et al. Sci Rep. .

Abstract

A therapeutic decision in the treatment of Tis/T1a glottic carcinoma with radiotherapy (RT) or transoral laser surgery (TOS) is still an open issue. Oncologic outcome and voice quality may support the choice for the latter To conduct a systematic review and meta-analysis to compare oncologic and functional outcomes of TOS and RT as treatment options for Tis/T1a glottic cancer. Literature research on online databases was carried out. Potentially eligible articles were reviewed. Relevant articles were selected and evaluated. There was statistical significance favoring patients initially treated with TOS when it comes to overall survival, disease-specific survival and larynx preservation. No difference in local control was found. TMF, Jitter and Shimmmer measurements presented statistically significant results in favor of RT. Self-assessment of voice quality (VHI) and f0 showed no statistically significant differences. Maximum Phonation Time (MPT) had a better response to RT. There is a trend in favor of RT. Tis/T1a glottic cancer patients submitted to TOS had significant overall and disease specific survival and had fewer risks of having a total laryngectomy, when compared to the radiotherapy group. The self-assessment of voice quality and f0 did not show any difference; however, Jitter, Shimmer and MPT measurements favored radiotherapy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Selection flow of articles for the systematic revision.
Figure 2
Figure 2
Forest plot chart comparing microsurgery to radiotherapy in relation to overall survival.
Figure 3
Figure 3
Chart shows Forest plot comparing microsurgery to radiotherapy in relation to specific mortality.
Figure 4
Figure 4
(A) Forest plot chart comparing microsurgery to radiotherapy in relation to local control and (B) funnel plot to identify studies with high heterogeneity in the evaluation of local control.
Figure 5
Figure 5
Forest plot chart comparing microsurgery to radiotherapy in relation to larynx preservation.
Figure 6
Figure 6
(A) Forest plot chart comparing microsurgery to radiotherapy in relation to maximum phonation time and (B) Funnel plot identifying a paper with high heterogeneity in the evaluation of maximum phonation time.
Figure 7
Figure 7
(A) Forest plot chart comparing microsurgery to radiotherapy in relation to fundamental frequency (f0) and (B) Funnel plot demonstrating that there was no heterogeneity in the evaluation of the fundamental frequency.
Figure 8
Figure 8
(A) Forest plot comparing microsurgery to radiotherapy in relation to Jitter and (B) Funnel plot chart showing paper with Jitter heterogeneity.
Figure 9
Figure 9
(A) Forest plot chart comparing microsurgery to radiotherapy in relation to Shimmer and (B) Funnel plot chart identifying 2 papers with high heterogeneity in Shimmer’s evaluation.
Figure 10
Figure 10
(A) Forest plot chart comparing microsurgery to radiotherapy in relation to VHI and (B) Funnel plot identifying 2 papers with high heterogeneity between the arms radiotherapy versus microsurgery in the VHI evaluation.
See this image and copyright information in PMC

References

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