Laser Surgery versus Radiotherapy for T1-T2N0 Glottic Cancer: A Meta-Analysis

Background: Laser surgery and radiotherapy are commonly used to treat glottic cancer. Objective of Review: To compare outcomes and cost of laser surgery versus radiotherapy for T1–T2N0 glottic cancer. Type of Review: Meta-analysis. Search Strategy: The Cochrane Central Register of Controlled Trials, Ovid MEDLINE In-Process & Other NonIndexed Citations, Embase, Web of Science (1990–2010) were searched electronically. Three Chinese journals in otolaryngology were searched manually. Evaluation Method: Retrieved studies were analyzed with Review Manager 5.0 software. Methodological and outcome heterogeneity was analyzed using the 2 test and the I 2 test. Homogeneous and heterogeneous data were analyzed using a fixed random effect model. Results: Eleven studies involving 1,135 patients were included in the analysis. The cure rate did not differ between patients receiving laser surgery versus radiotherapy. Results on voice preservation were inconclusive. The overall cost for laser surgery was lower. Conclusions: The quality of the reported clinical studies is limited. Received: September 27, 2010 Accepted after revision: February 21, 2011 Published online: October 15, 2011 Binquan Wang Otorhinolaryngology Head and Neck Surgery The First Affiliated Hospital of Shanxi Medical University Taiyuan 030001 (China) Tel. +86 351 463 9988, E-Mail wbq_xy @ hotmail.com © 2011 S. Karger AG, Basel 0301–1569/11/0736–0336$38.00/0 Accessible online at: www.karger.com/orl D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /2 3/ 20 17 4 :1 7: 16 P M A Meta-Analysis of T1–T2N0 Glottic Cancer ORL 2011;73:336–342 337 cal cords produce readily noticeable voice changes [3] ; (2) the true vocal cords in the glottis region of the larynx are devoid of lymphatic drainage [4] . Early glottic cancer has a relatively good prognosis [5, 6] . The most common treatment options are endoscopic laser surgery and radiotherapy. The goal of the treatment for T1–T2N0M0 glottic cancer is to cure the disease while preserving the vocal cords. Both laser surgery and radiotherapy could achieve high cure rates, but which treatment is superior in voice preservation remains controversial [7–10] . Superior voice quality has been reported after radiotherapy in several studies [9–11] whereas one study reported superior voice quality after laser treatment [7] . There are a few reviews on the use of endoscopic laser surgery and radiotherapy in the treatment of early glottic cancer [11, 12] , and none of these reviews comprehensively assessed cure rates, voice function-preserving capacity and treatment costs. The present meta-analysis is based on reports published in the past two decades. Specifically, carbon dioxide endoscopic laser surgery was compared to radiotherapy in patients with T1–T2N0M0 glottic cancer. Parameters included overall survival, voice preservation and cost.