Factors Affecting Voice Quality in Early Glottic Cancer Before and After Radiotherapy

  • Irena Hočevar-Boltežar University Medical Centre Ljubljana, Department of Otorhinolaryngology and Head & Neck Surgery Ljubljana, Slovenia
  • Jana Mekiš University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
  • Primož Strojan


Background: Radiotherapy (RT) is a successful mode of treatment for early glottic cancer. The aim of the study was to assess voice quality both before and 3 months after successful RT using multimodal methods while also identifying the factors affecting it.

Methods: In 50 patients with T1 glottic carcinoma, the subjective (patients’ assessment of voice quality [VAS], Voice Handicap Index [VHI] questionnaire, phoniatricians’ assessment using the grade/roughness/breathiness [GRB] scale), and objective assessments (fundamental laryngeal frequency [F0], jitter, shimmer, maximum phonation time [MPT]) of voice quality were performed before RT and 3 months post-RT. The data on gender, age, extent of the tumors, biopsy types, smoking, local findings, and RT were obtained from the medical documentation. 

Results: Three months after the treatment, VAS, VHI, G and R scores, F0, and MPT significantly improved in comparison with their assessment prior to treatment. Before the treatment, the involvement of the anterior commissure significantly deteriorated jitter (p=0.044) and the involvement of both vocal folds deteriorated jitter (p=0.003) and shimmer (p=0.007). After the RT, F0 was significantly higher in the patients with repeated biopsy than in the others (p=0.047). In patients with post-RT changes, the B score was significantly higher than in those without post-RT changes (p=0.029).

Conclusion: Voice quality already significantly improved three months after the treatment of glottic cancer. The main reason for the decreased voice quality prior to treatment is the tumor’s extent. Post-RT laryngeal changes and repeated biopsies caused more scarring on vocal folds adversely influencing voice quality after the treatment.

How to Cite
Hočevar-Boltežar, I., Mekiš, J., & Strojan, P. (2019). Factors Affecting Voice Quality in Early Glottic Cancer Before and After Radiotherapy. Radiology and Oncology, 53(4), 459-464. Retrieved from https://www.radioloncol.com/index.php/ro/article/view/3326
Clinical oncology