Is Single Cord Irradiation Going to Be a New Standard for T1a Glottic Carcinoma?

Uzel, Esengul Kocak; Figen, Metin; Uzel, Ömer

doi:10.3389/fonc.2020.01447

Cited by 7 publications

(5 citation statements)

References 37 publications

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“…This resulted in a significant reduction of the radiation dose to the adjacent organs. [17][18][19] In the case of ESGC, it was found to be noninferior to LRT. 18,20,21 Patient-reported voice quality is considered an important outcome during counseling in ESGC.…”

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confidence: 97%

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Longitudinal Patient‐Reported Voice Quality in Early‐Stage Glottic Cancer

Dorr

Sewnaik

Andrinopoulou

et al. 2023

Otolaryngol.--head neck surg.

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Objective. Patient-reported voice quality is an important outcome during counseling in early-stage glottic cancer. However, there is a paucity of adequate longitudinal studies concerning voice outcomes. This study aimed to investigate longitudinal trajectories for patient-reported voice quality and associated risk factors for treatment modalities such as transoral CO 2 laser microsurgery, single vocal cord irradiation, and local radiotherapy.Study Design. A longitudinal observational cohort study. Setting. Tertiary cancer center.Methods. Patients treated for Tcis-T1b, N0M0 glottic cancer were included in this study (N = 294). The Voice Handicap Index was obtained at baseline and during follow-up (N = 1944). Mixed-effects models were used for investigating the different trajectories for patient-reported voice quality.Results. The mean follow-up duration was 43.4 (SD 21.5) months. Patients received transoral CO 2 laser microsurgery (57.8%), single vocal cord irradiation (24.5%), or local radiotherapy (17.5%). A steeper improvement during the first year after treatment for single vocal cord irradiation (−15.7) and local radiotherapy (−12.4) was seen, compared with a more stable trajectory for laser surgery (−6.1). All treatment modalities showed equivalent outcomes during long-term follow-up. Associated risk factors for different longitudinal trajectories were age, tumor stage, and comorbidity. Conclusion.Longitudinal patient-reported voice quality after treatment for early-stage glottic cancer is heterogeneous and nonlinear. Most improvement is seen during the first year of follow-up and differs between treatment modalities. No clinically significant differences in longterm trajectories were found. Insight into longitudinal trajectories can enhance individual patient counseling and provide the foundation for an individualized dynamic prediction model.

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confidence: 97%

“…SVCI is a new technique, developed in our institution, that uses a mild hypofractionated scheme with limited volumes and highly conformal target coverage. This resulted in a significant reduction of the radiation dose to the adjacent organs 17‐19 . In the case of ESGC, it was found to be noninferior to LRT 18,20,21 …”

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confidence: 99%

Longitudinal Patient‐Reported Voice Quality in Early‐Stage Glottic Cancer

Dorr

Sewnaik

Andrinopoulou

et al. 2023

Otolaryngol.--head neck surg.

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“…The latter can be divided in local radiotherapy with irradiation of the larynx in a total dose of 60 to 66 Gy in 25 to 33 fractions, and single vocal cord irradiation with a mild hypofractioned scheme up to 58.08 Gy in 16 fractions. This resulted in a significant reduction of the radiation dose to the adjacent organs 29‐31 . For ESGC, it showed noninferiority compared to local radiotherapy 30,32,33 .…”

Section: Methodsmentioning

confidence: 99%

“…This resulted in a significant reduction of the radiation dose to the adjacent organs. [29][30][31] For ESGC, it showed noninferiority compared to local radiotherapy. 30,32,33 Tumorspecific and patient-specific data were retrospectively obtained from Erasmus Medical Center patient records.…”

Section: Main Outcomes and Measuresmentioning

confidence: 99%

“…Treatment modalities in this study are transoral laser microsurgery and radiotherapy. [28][29][30][31] The latter can be divided in local radiotherapy with irradiation of the larynx in a total dose of 60 to 66 Gy in 25 to 33 fractions, and single vocal cord irradiation with a mild hypofractioned scheme up to 58.08 Gy in 16 fractions. This resulted in a significant reduction of the radiation dose to the adjacent organs.…”

Section: Main Outcomes and Measuresmentioning

confidence: 99%

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Individualized Dynamic Prediction Model for Patient‐Reported Voice Quality in Early‐Stage Glottic Cancer

Dorr

Andrinopoulou

Sewnaik

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveEarly‐stage glottic cancer (ESGC) is a malignancy of the head and neck. Besides disease control, preservation and improvement of voice quality are essential. To enable expectation management and well‐informed decision‐making, patients should be sufficiently counseled with individualized information on expected voice quality. This study aims to develop an individualized dynamic prediction model for patient‐reported voice quality. This model should be able to provide individualized predictions at every time point from intake to the end of follow‐up.Study DesignLongitudinal cohort study.SettingTertiary cancer center.MethodsPatients treated for ESGC were included in this study (N = 294). The Voice Handicap Index was obtained prospectively. The framework of mixed and joint models was used. The prognostic factors used are treatment, age, gender, comorbidity, performance score, smoking, T‐stage, and involvement of the anterior commissure. The overall performance of these models was assessed during an internal cross‐validation procedure and presentation of absolute errors using box plots.ResultsThe mean age in this cohort was 67 years and 81.3% are male. Patients were treated with transoral CO2 laser microsurgery (57.8%), single vocal cord irradiation up to (24.5), or local radiotherapy (17.5%). The mean follow‐up was 43.4 months (SD 21.5). Including more measurements during prediction improves predictive performance. Including more clinical and demographic variables did not provide better predictions. Little differences in predictive performance between models were found.ConclusionWe developed a dynamic individualized prediction model for patient‐reported voice quality. This model has the potential to empower patients and professionals in making well‐informed decisions and enables tailor‐made counseling.

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