Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France.
Laryngoscope. 2014 Jun;124(6):1398-401. doi: 10.1002/lary.24445. Epub 2013 Nov 13.
OBJECTIVES/HYPOTHESIS: To compare voice handicap and quality of life after radiotherapy (RT) versus transoral laser surgery (LS) for T1a glottic carcinoma.
Retrospective study (1996-2011) of patients treated with RT or LS for T1a glottic squamous cell carcinoma with curative intent.
Disease-free patients were assessed using Voice Handicap Index (VHI 30) and European Organization for Research and Treatment of Cancer Head and Neck Quality of Life (EORTC QLQ-HN35) questionnaires.
Of 147 patients, 95 (65%) completed the questionnaires: fifty-one patients an average of 8 years after RT and 44 patients an average of 4 years after LS (no difference in age or sex ratio). The average total VHI 30 was 13.1 for RT and 29.2 for LS (P < .0001), with average emotional, physical and functional subscores significantly different. The average total EORTC QLQ-HN35 was 37.7 for RT versus 40.7 for LS (P = .7), with a difference only in the speaking subscore (P = .04).
Long-term subjective voice-related quality of life was worse after LS, with no difference in other domains. These results should be interpreted in light of the biases inherent in retrospective studies.
目的/假设：比较 T1a 声门型喉癌放疗（RT）与经口激光手术（LS）治疗后的嗓音障碍和生活质量。
回顾性研究（1996-2011 年），对接受 RT 或 LS 治疗的 T1a 声门型鳞状细胞癌患者进行随访。
采用嗓音障碍指数（VHI 30）和欧洲癌症研究与治疗组织头颈部生活质量问卷（EORTC QLQ-HN35）对无病患者进行评估。
在 147 例患者中，95 例（65%）完成了问卷调查：51 例患者平均随访 8 年，44 例患者平均随访 4 年（年龄和性别比例无差异）。RT 的平均总 VHI 30 为 13.1，LS 为 29.2（P<.0001），情绪、身体和功能子评分的平均值差异显著。RT 的平均总 EORTC QLQ-HN35 为 37.7，LS 为 40.7（P=.7），仅在言语子评分上存在差异（P=.04）。
LS 治疗后的长期嗓音相关生活质量较差，但其他方面无差异。这些结果应结合回顾性研究固有的偏倚进行解释。
4 级。
