sakineh bagherzadeh

One of the side effects of radiation therapy for non-laryngeal head and neck cancers is laryngeal damage, leading to vocal disorders. Considering the impact of voice on the patient’s quality of life, the long-term follow-up after treatment using a voice handicap index questionnaire is the aim of this study.

This descriptive-analytical study included 30 patients with non-laryngeal head and neck cancers and 30 normal individuals. Specialized examinations have confirmed damage in the larynx. The VHI Questionnaire sub-group scores were assessed at 6 and 24 months post-treatment, along with the voice quality of patients and a control group at 24 months post-treatment. Pearson's correlation coefficient test was used to assess the relationship between each sub-group of the questionnaire at the two mentioned time points.

The patients' examination results revealed a significant decrease in the total questionnaire scores from 19.8 at 6 months to 11.37 at 24 months post-treatment (P < 0.05). The study found no significant difference between the patient and control groups after 24 months (P < 0.05). The questionnaire sub-group scores showed a negative correlation, indicating a trend of decreasing scores at the final follow-up.

This study showed that after the treatment, the radiation damage decreased over time and improved the patient's quality of life.

Laryngeal damages after chemoradiation therapy (RT) in nonlaryngeal head‑and‑neck cancers (HNCs) can cause voice disorders and finally reduce the patient’s quality of life (QOL). The aim of this study was to evaluate voice and predict laryngeal damages using statistical binary logistic regression (BLR) models in patients with nonlaryngeal HNCs.

This cross‑section experimental study was performed on seventy patients (46 males, 24 females) with an average age of 50.43 ± 16.54 years, with nonlaryngeal HNCs and eighty individuals with assumed normal voices. Subjective and objective voice assessment was carried out in three stages including before, at the end, and 6 months after treatment. Eventually, the Enter method of the BLR was used to measure the odds ratio of independent variables.

In objective evaluation, the acoustic parameters except for F0 increased significantly (P < 0.001) at the end treatment stage and decreased 6 months after treatment. The same trend can be seen in the subjective evaluations, whereas none of the values returned to pretreatment levels. Statistical models of BLR showed that chemotherapy (P < 0.05), mean laryngeal dose (P < 0.05), V50 Gy (P = 0.002), and gender (P = 0.008) had the greatest effect on incidence laryngeal damages. The model based on acoustic analysis had the highest percentage accuracy of 84.3%, sensitivity of 87.2%, and the area under the curve of 0.927.

Voice evaluation and the use of BLR models to determine important factors were the optimum methods to reduce laryngeal damages and maintain the patient’s QOL.