QUALITY-OF-LIFE AND VOICE IN PATIENTS WITH LARYNGEAL CARCINOMA - A POSTTREATMENT COMPARISON OF LARYNGECTOMY (SALVAGE SURGERY) VERSUS RADIOTHERAPY

Objectives: This study was designed 60 compare the voice and the quali ty of life (QOL) of laryngeal cancer patients receiving treatment with radical radiotherapy with or without laryngectomy as salvage surgery. We also compared the patients' own perceptual ratings of their voice to the perceptual ratings of a group of listeners. Study Design: Two g roups of laryngeal cancer patients were studied. Methods: Fourteen irr adiated laryngeal speakers with preserved larynx were matched with 14 salvage surgery laryngectomized patients speaking with tracheoesophage al prosthesis (TEP). To measure patients' QOL, we used the European Or ganisation for Research and Treatment of Cancer Quality of Life Core Q uestionnaire (EORTC QLQ-C30), the EORTC Head and Neck module (EORTC QL Q-H&N35), the Hospital Anxiety and Depression scale (HAD) and a study- specific questionnaire. For the perceptual speech evaluation we used v isual analog scales. Results: The perceptual ratings of speech intelli gibility, voice quality, and speech acceptability showed a significant difference between the treatment groups. Both the patients who receiv ed treatment with radiotherapy and the listeners rated the irradiated laryngeal voices higher than the tracheoesophageal speech. The larynge ctomized patients scored significantly better than the patients treate d with radical radiotherapy on the question about hoarseness. No other significant difference was found for the QOL functions and symp toms. Conclusion: When patients treated with radiotherapy were compared wit h patients treated with laryngectomy as salvage surgery, QOL was simil ar, only small differences being found in the perceptual speech evalua tion.