Department of Otorhinolaryngology-Section of Head and Neck Surgery, Goethe-University Medical Center, Frankfurt/Main, Germany.
Department of Otorhinolaryngology-Section of Phoniatrics, Goethe-University Medical Center, Frankfurt/Main, Germany.
Head Neck. 2019 Apr;41(4):899-907. doi: 10.1002/hed.25474. Epub 2019 Jan 31.
Local control rate (LCR) of early glottic cancer is high after radiation therapy or transoral laser microsurgery (TLM). The aim of this study was to investigate functional voice outcome after TLM using a microvessel-ablative potassium-titanyl-phosphate (KTP) laser in comparison with a gold standard cutting CO laser.
The primary end point of this prospective, randomized, single-blinded, clinical phase II study with control group was voice outcome during a follow-up of 6 months assayed by Voice Handicap Index (VHI-30)-questionnaires in patients with unilateral high-grade dysplasia, carcinoma in situ or early glottic cancer undergoing TLM-KTP (n = 8) or TLM-CO (n = 12). The secondary end point was LCR.
Starting from the 9-week-follow-up visit, TLM-KTP yielded significantly reduced VHI scores compared to TLM-CO . No relapse occurred after TLM-KTP in contrast to one recurrence after TLM-CO within 6 months.
Multicenter phase II or III studies on voice outcome or local control rate after TLM-KTP in early glottic cancer are warranted enrolling larger patient cohorts.
放射治疗或经口激光微创手术(TLM)后早期声门癌的局部控制率(LCR)较高。本研究旨在通过微血管消融性钾钛磷酸(KTP)激光与金标准切割 CO 激光比较,探讨 TLM 后的功能嗓音结果。
这是一项前瞻性、随机、单盲、对照的 II 期临床研究,主要终点是 6 个月随访期间通过嗓音障碍指数(VHI-30)问卷评估单侧高级别不典型增生、原位癌或早期声门癌患者的嗓音结果,TLM-KTP(n=8)或 TLM-CO(n=12)。次要终点为 LCR。
从 9 周随访开始,TLM-KTP 的 VHI 评分明显低于 TLM-CO。TLM-KTP 后无复发,而 TLM-CO 后 6 个月内有 1 例复发。
需要开展多中心 II 期或 III 期研究,以评估 KTP 激光治疗早期声门癌后的嗓音结果或局部控制率,纳入更大的患者队列。