Laser surgery versus radiotherapy for T1a glottic carcinoma: a meta-analysis of oncologic outcomes

Abstract

Objectives: A meta-analysis was conducted to compare oncologic outcomes for patients of T1a glottic carcinoma who were treated with laser surgery (LS) or radiotherapy (RT).

Methods: All related studies published up to October 2016 were acquired by searching PubMed, EMBASE, and Cochrane were conducted by two authors, with the index words: vocal, glottis, larynx, laser, surgery, cordectomy, radiotherapy, radiation, irradiation, carcinoma, and cancer. Relative studies which compared oncologic outcomes between LS and RT were included.

Results: A total of nine eligible studies were included for the analysis, which contained two prospective studies and seven retrospective studies. LS has increased larynx preservation (OR = 3.86, 95% CI = 1.47–10.13, p = .006) compared with RT group. No statistical difference was observed between LS group and RT group in terms of local control, overall survival, and disease-specific survival. There was a slight trend in terms of local control, overall survival, and disease-specific survival that all favored LS, although all data did not reach the level of statistical significance.

Conclusions: The results of this meta-analysis indicate that LS may be a better option for the treatment of T1a glottic carcinoma because patients underwent LS may benefit from increased larynx preservation compared with RT. However, more multi-center randomized controlled trials would be urgently needed to prove these differences.

Chinese abstract

目的：我们进行了文献分析, 其目的是比较对T1a声门癌患者用激光手术（LS）或放射治疗（RT）的肿瘤学结果。

方法：通过搜索PubMed、EMBASE和Cochrane, 获得了截至2016年10月的所有相关的已发表的研究文献。该搜索由两位作者进行, 用了索引词：声带、声门、喉、激光、手术、脊髓切除术、放射治疗、辐射、照射、癌和癌症。包括了比较LS和RT之间肿瘤学结果的相关性研究。

结果：共纳入9项符合我们意图的研究, 其中包括两项前瞻性研究和7项回顾性研究。与RT组相比, LS增加了喉部保留（OR =3.86,95％, CI =1.47-10.13, p = .006）。在局部控制、总体存活和疾病特定性存活方面, LS组和RT组之间无统计学差异。尽管所有数据均未达到统计学显著性水平, 但局部控制、总体存活和疾病特定性存活率都有稍偏向LS的趋势。

结论：文献分析的结果表明, LS可能是治疗T1a声门癌的更好选择, 因为与RT相比, 接受LS治疗的患者可能受益于增加的喉部保留。然而, 迫切需要更多的多中心随机对照试验来证明这些差异。

Keywords:

• Laser therapy
• radiotherapy
• laryngeal neoplasms
• glottis
• meta-analysis

Acknowledgements

We are grateful to Dr. Hui-zi Li and Dr. Qin Zhu for their statistical support for the study.

Disclosure statement

The authors declare no conflicts of interest in the work. The authors alone are responsible for the content and writing of the paper.