VOCAL FUNDAMENTAL-FREQUENCY MEASURES AS A REFLECTION OF TUMOR RESPONSE TO CHEMOTHERAPY IN PATIENTS WITH ADVANCED LARYNGEAL-CANCER

The fundamental frequency (F-0) characteristics of 19 male patients wi th advanced laryngeal cancer, treated with cisplatin-based chemotherap y as part of a Larynx Preservation Protocol (LPP), were measured befor e each of three cycles of chemotherapy received before definitive radi otherapy (RT). In these select patients, for whom chemotherapy resulte d in greater than or equal to 50% decrease in the tumor bulk, it was f ound that mean F-0 was essentially unaffected by the disease and did n ot change over the course of chemotherapy, although the cycle of their treatment could be differentiated by both speaking F-0 variability (p itch sigma) and F-0 perturbation (jitter). Although these measures fai led to distinguish between those patients showing a complete response (CR) (no measurable disease) versus a partial (PR) (residual) tumor re sponse at the primary disease site, the significant changes observed i n both groups indicate that frequency variation measures could prove v aluable in the documentation of tumor response to nonsurgical therapeu tic intervention if the voice is directly affected. Additional assessm ent of 15 age- and disease-matched patients who showed minimal or no p rimary response to the chemotherapy showed no significant change in an y of the frequency measures after one chemotherapy cycle, suggesting t hat vocal improvement seen in the successful chemotherapy patients was not due to postbiopsy healing or other systemic influence unassociate d with tumor reduction.