This retrospective analysis focusses on the impact of
therapy on perceived long-term post-
cancer treatment function. A validated questionnaire including items and components for the assessment of communicative ability, quality of voice and swallowing was sent to 129 patients. All patients were treated between 1998 and 2007. A total of 76 patients (58.9%) with
carcinoma of the larynx or hypopharynx replied to the questionnaire. Data was evaluated retrospectively.
Therapy delivered was definitive radio(chemo)
therapy (defchRT/RT) (21/76, 28%),
laryngectomy + radio(chemo)
therapy (LE + chRT/RT) (28/76, 37%), or larynx conservation surgery + radio(chemo)
therapy (LCS + chRT/RT) (27/76, 36%).
Radiotherapy was administered using 2D- or 3D-conformal planning. The most common concomitant
chemotherapy delivered was
cisplatin +
5FU. For statistical analyses of the components, averages were calculated and tested using the Kruskal-Wallis test and the U-test of Mann and Whitney. Differences were assessed by the Monte Carlo method or Fisher's exact test. The single item rates were compared with Fisher's exact test. Mean follow-up was 56.7 months (range, 8-130 months). After defchRT/RT, patients trended towards more substantial-strong
hoarseness compared with LCS + chRT/RT (P = 0.2). After LE, patients were dissatisfied with their
artificial larynx/electrolarynx and the tone of their voice (P = 0.3, P = 0.07) and communicative ability (P = 0.005, P = 0.008) compared with those treated with defchRT/RT and LCS + chRT/RT, respectively.
Dysphagia and additional percutaneous endoscopic
gastrostomy (PEG) feeding were more frequent after defchRT/RT in comparison with the other two groups (P < 0.05). Voice quality and communicative ability were slightly worse after defchRT/RT and LE + chRT/RT, but satisfying with all treatment modalities. Further development of the
therapy approach is necessary to reduce long-term side effects, with measures of post-treatment function as important endpoints.