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. 2022 Jun;42(3):243-249.
doi: 10.14639/0392-100X-N1992.

Voice outcomes in patients with advanced laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy

César Álvarez-Marcos  1   2 , Andrea Vicente-Benito  3 , Águeda Gayol-Fernández  3 , Daniel Pedregal-Mallo  1   2 , Paloma Sirgo-Rodríguez  3 , Liliana Santamarina-Rabanal  3 , José Luis Llorente  1   2 , Fernando López  1   2 , Juan Pablo Rodrigo  1   2
Affiliations

Voice outcomes in patients with advanced laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy

César Álvarez-Marcos et al. Acta Otorhinolaryngol Ital. 2022 Jun.

Abstract
in English, Italian

Objective: Patients with locally advanced laryngeal and hypopharyngeal cancer (LHC) are often treated with chemo-radiotherapy to avoid total laryngectomy, although voice problems may occur even if not markedly manifest. We sought to evaluate the impact of chemoradiation on voice and quality of life.

Methods: We studied 21 patients with locally advanced LHC with tumour control at least two years after chemo-radiotherapy. None manifested clinical symptoms related to the treatment and maintained an activity considered as within normal limits. All patients had a voice handicap index (VHI) of less than 15. Voice function was evaluated by perceptual vocal analysis (CAPE-V) and aerodynamic and acoustic study. Quality of life was assessed with the EORTC-H&N35 (voice items 46, 53 and 54).

Results: Voice changes were frequent, with alterations in all CAPE-V attributes, and predominantly type II and III spectrograms in acoustic analysis (78%). The EORTC-H&N35 scale showed a reduction in scores in 10-40% of items related to voice.

Conclusions: Subclinical voice disorders are common after chemo-radiotherapy. Although patients consider vocal impairment to be very minor and to not interfere with their daily life, it may contribute to a reduced quality of life.

Risultati vocali in pazienti con cancro laringeo e ipofaringeo avanzato trattati con chemio-radioterapia.

Obiettivo: I pazienti con cancro della laringe e dell’ipofaringe (LHC) localmente avanzato vengono spesso trattati con chemio-radioterapia per evitare la laringectomia totale, anche se si possono presentare problemi disfonici. Abbiamo cercato di valutare l’impatto della chemioradioterapia sulla voce e sulla qualità della vita.

Metodi: Abbiamo studiato 21 pazienti con LHC localmente avanzato, con controllo locale di malattia a 2 anni dal termine dei trattamenti chemio-radioterapici. Nessuno di essi lamenta sintomi clinici correlati a detto trattamento, essendo ritornati a una normale attività di vita. Tutti i pazienti mostrano un indice di handicap vocale (VHI) inferiore a 15. La funzione vocale è stata valutata mediante analisi percettiva vocale (CAPE-V) e studio aerodinamico e acustico. La qualità della vita è stata valutata con l’EORTC-H&N35 (voci 46, 53 e 54).

Risultati: I cambiamenti di voce sono risultati essere frequenti, con alterazioni del CAPE-V e spettrogrammi prevalentemente di tipo II e III nell’analisi acustica. (78%). La scala EORTC-H&N35 mostra una riduzione del punteggio tra il 10-40% nelle voci relative alla funzione vocale.

Conclusioni: I disturbi della voce subclinici sono comuni dopo la chemio-radioterapia. Sebbene i pazienti considerino la compromissione vocale di minore importanza, non interferendo tali alterazioni con la loro vita quotidiana, tali disturbi potrebbero contribuire a una ridotta qualità della vita.

Keywords: laryngeal and hypopharyngeal cancer; organ-preservation protocol; quality of life; voice.

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