Long-term study of vocal dysfunction and quality of life in patients with non-laryngeal head and neck cancers post chemo-radiation therapy: Results of prospective analysis

Background: Vocal problems caused by Chemo-radiation therapy (CRT) can affect a patient's quality of life (QOL) for a long time. This study aims to follow up and evaluate the voice of Persian-speaking patients with non-laryngeal head and neck cancer up to eighteen months after treatment. Material and Methods: This prospective study was conducted to assess the voice of disease-free patients with various head and neck malignancies treated with CRT. The voice assessment was conducted at four points: before, at the end of treatment, and six and eighteen months after treatment. At the time of the last assessment, there were only 30 patients with an average age of 48.86 +/- 14.89 and in the range of (18-75) years. For a comprehensive assessment, acoustic, expert-rater, and subjective evaluation of voice was conducted. The Pearson correlation coefficient for all acoustic parameters, subgroups of the Persian VHI-30 questionnaire, and perceptual measurements were computed. The effect of essential factors on patient QOL associated with the voice in different groups was examined. Results: All acoustic parameters, other than fundamental and habitual frequencies, subjective and perceptual data values increased significantly (P < 0.001) during the treatment and decreased at the last assessment. None of the values have returned to pre-treatment levels. There was a significant relationship between some acoustic parameters, Persian VHI-30 questionnaire values, and G on the GRBAS scale. Chemotherapy and smoking were influential factors in patients' QOL. Conclusions: Vocal problems and reduced voice related QOL in patients treated with CRT may persist for years after treatment.