Abstract
Background Very few studies have been conducted to compare carbon dioxide laser microsurgery (CO2-LS) with low-temperature plasma radiofrequency ablation (LTP-RFA) in treating T1a glottic cancer. Therefore, we conducted this study to compare the efficacy of CO2-LS and LTP-RFA to define a superior therapeutic modality for T1a glottic cancer. Methods Patients (n=131) with T1a glottic cancer were recruited between January 2010 and September 2014. The included patients were randomly assigned to either receive CO2-LS (n=65) or LTP-RFA (n=66). We conducted the following multidimensional vocal assessments: (i) videostroboscopic evaluation; (ii) auditory-perceptual evaluation; (iii) aerodynamics/ efficiency; (iv) acoustics; and (v) self-assessment questionnaires. Meanwhile, the surgery time and three-year overall survival rates in two groups were recorded. The predefined primary endpoint was overall survival, and the minimum follow-up time was set to six months. Results After treatment, we found that the structure and vibration of vocal cord might recover more quickly in patients receiving LTP-RFA than in patients receiving CO2-LS, and moreover, the patients in the LTP-RFA group had the better vocal functions. Meanwhile, the surgery time was significantly less in the LTP-RFA group (8.83±1.59 minutes) than in the CO2-LS group (12.49±1.40 minutes) (p<0.00001). In addition, the two intervention methods had the similar three-year overall survival rates (94% versus 96%, p=0.58). Conclusion These results indicated that both LTP-RFA and CO2-LS could effectively treat T1a glottic cancer, and LTP-RFA might have some advantages in voice function. Limited by the relatively small sample size, future studies were needed to validate our conclusion.
Highlights
Laryngeal squamous cell carcinoma arises from the mucosal surface of the larynx, which is one of the most common head and neck cancers worldwide
Patients met the following criteria were recruited: (i) patients with T1a glottic cancer; (ii) patients aged 18 years or older without mental disorders or systemic diseases; (iii) patients were not previously treated for vocal fold or previous cancer; (iv) no neck lymph node metastasis was detected by neck color ultrasonic inspection and enhanced CT before surgery; and (v) both CO2LS and low-temperature plasma radiofrequency ablation (LTP-RFA) were appropriate after a detailed discussion among the clinician, patient and family had occurred
There were no significant differences in baseline data between the two groups
Summary
Laryngeal squamous cell carcinoma arises from the mucosal surface of the larynx, which is one of the most common head and neck cancers worldwide. Along with the enhanced of health awareness and the increased of examination methods, more and more laryngeal cancer patients have been identified at an early stage [2]. Among these patients, glottic cancer is the most common laryngeal cancer. Very few studies have been conducted to compare carbon dioxide laser microsurgery (CO2-LS) with low-temperature plasma radiofrequency ablation (LTP-RFA) in treating T1a glottic cancer. We conducted this study to compare the efficacy of CO2-LS and LTP-RFA to define a superior therapeutic modality for T1a glottic cancer. These results indicated that both LTP-RFA and CO2-LS could effectively treat T1a glottic cancer, and LTP-RFA might have some advantages in voice function. Limited by the relatively small sample size, future studies were needed to validate our conclusion
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