The Voice Quality After Laser Surgery Versus Radiotherapy Of Tla Glottic Carcinoma: Systematic Review And Meta-analysis

Objective: The voice quality assessment of laser surgery(LS)in comparison with radiotherapy(RT)remains uncertain in the treatment of T1 a glottic carcinoma.This systematic review and meta-analysis were conducted to compare the voice quality of the two treatments.Methods: Searches were conducted in PubMed,Web of Science,Embase,Cochrane Library,Chinese biomedical literature datebase,CNKI and Wanfang digital journals with the following index words: glotti*,layn*,vocal cord,vocal,surgery,cordectomy,laser,radiation,irradiation,radiotherapy,cancer,and carcinoma for relative studies that compared the voice quality between LS and RT.Random-effect models were used,and heterogeneity was assessed.Results: A total of 15 studies were included in the analysis,consisting of 1 randomized controlled trial,1 prospective study,and 13 retrospective studies.RT has increased the maximum phonation time(MPT;mean difference [MD] =-2.26,95% confidence interval [CI] =-3.94 to-0.59,P=0.008)and decreased the fundamental frequency(MD =14.41,95% CI =10.64 to 18.19,P<0.00001)in comparison with LS.No statistical difference was observed between the two groups in terms of Voice Handicap Index(MD=5.86,95%CI=-5.22 to 16.94),P=0.30),Jitter(MD=0.75,95%CI=-0.28 to 1.79),P=0.15),Shimmer(MD=1.07,95%CI=-0.60 to 2.75,P=0.21),airflow rate(MD=21.46,95%CI=-78.79 to 121.72),P=0.67)and GRBAS scale.Conclusion: RT may be a better choice for T1 a glottic carcinoma treatment compared with LS because patients undergoing RT may have the advantage of increased MPT and decreased fundamental frequency.Therefore,more multicenter,randomized,controlled trials are urgently needed to verify these differences.