Comparison of the Outcome of Surgery and Radiotherapy in the Treatment of Early Carcinoma of the Larynx

Background: The most prevalent disease to afflict the head and neck region is laryngeal cancer. The early stage of this disease, T1T2N0M0, has a higher chance of recovery than the other phases. Radiation therapy and surgery are its therapeutic techniques.

Objective: To Compare the outcome of surgery and radiotherapy in the treatment of early carcinoma of the larynx

Methods: This cross-sectional study was carried out at tertiary hospital Dhaka from January 2022 to January 2023. Where A total of 200 Patients of carcinoma of the larynx are evaluated properly by detailed history taking, clinical examination and relevant investigation. During the study two groups of patients were dealt separately; Group-1: Surgery using LASER, n=100 and Group-2: radiotherapy, n=200. All the patients were followed up after 2 weeks, 1 month and then three monthly for one year.

Results: During the study, supraglottis carcinoma was found in 65% of radiotherapy group and 70% in surgery group, glottic carcinoma was 35% & 30%, respectively in radiotherapy and surgery group. No case found with subglottic carcinoma. Where in surgery group 7% patients had haematoma, 5% patients had seroma & pharyngeal stenosis. In radiotherapy group 2.5% Severe radiation necrosis of skin & 3% had Respiratory distress following radiotherapy. . In the radiotherapy group, 25% cases were scored as normal and 45% as good. For the surgery group, 40% patients had good voice and speech, 35%r had moderate voice and speech, and 5% had poor voice and speech. This difference was statistically significant (p=.001). 14% of the irradiation group had a primary site recurrence compared with 20% in the surgery group at 12th months. There was a significant difference in the pattern of recurrence in the neck between the two treatment groups. Only 5% of those who were treated with irradiation had a recurrence in the neck. 14% of patients in the surgery group had a recurrence in the neck; this difference was statistically significant.

Conclusions: When treating early laryngeal cancer, radiation therapy and surgery are equally successful. However, patients who had radiation therapy had much improved speech and voice quality compared to those who received surgery.