Radiation better than surgery at preserving speech for patients with head and neck cancer

Patients suffering from advanced head and neck cancer affecting their larynx can maintain vocal function by undergoing a combination of radiation therapy and chemotherapy instead of surgery to remove the larynx, according to a study published in the December 1, 2005, issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of ASTRO, the American Society for Therapeutic Radiology and Oncology.

Doctors in the Department of Otolaryngology – Head and Neck Surgery at the University of Michigan in Ann Arbor, Mich., studied 97 patients with advanced laryngeal cancer. All of the patients were given an initial course of chemotherapy and depending on their response to that treatment, they either underwent a laryngectomy to remove the larynx or received radiation therapy coupled with chemotherapy.

The results showed that patients who were able to keep their larynx intact and underwent radiation therapy maintained a higher voice-related quality of life than those who had their larynx removed. While swallowing function was comparable between the two groups, understandability of speech was much better in patients who kept their larynx. In addition, 89 percent of patients with their larynx intact were able to obtain nutrition orally and without supplements, compared to 64 percent who underwent the laryngectomy. The overall three-year survival rate for all patients was 86 percent.

“Undergoing the radiation, chemotherapy combination can increase toxicity levels in some patients, but maintaining the overall quality of life for those patients justifies the potential for added toxicity,” said Kevin Fung, M.D., F.R.C.S.(C)., lead author of the study and currently a Head and Neck Surgeon at the University of Western Ontario in London, Ontario, Canada. “The overall survival rate is high for both sets of patients but those patients who respond well to the initial treatments and can avoid the surgery also avoid the social, emotional and physical side effects such as cosmetic disfigurement and speech alteration.”