TRANSORAL LASER SURGERY VERSUS RADIOTHERAPY: SYSTEMATIC REVIEW AND META-ANALYSIS FOR TREATMENT OPTIONS OF T1a GLOTTIC CANCER

Background. The objective of this study was to conduct a systematic review and meta-analysis to compare the oncologic and functional outcomes between transoral laser surgery (TLS) and radiotherapy (RT). Methods. An electronic library search of the relevant English- and Chinese-language literature was conducted. Potentially eligible articles were reviewed. Qualified articles were selected and evaluated. Results. No significant differences were identified between TLS and RT with respect to local control, overall survival, disease-specific survival, and posttreatment voice quality. However, larynx preservation was significantly higher in patients initially treated with TLS than those initially treated with RT. Conclusions. The approach for optimal treatment of T1a glottic cancer remains unanswered. This results from the relatively inconclusive evidence obtained from the current literature. Properly designed, prospective, randomized, or well-controlled studies will be required. Similar methodologies for treatment and reporting need to be established to make a valid and meaningful comparison between studies. (C) 2011 Wiley Periodicals, Inc. Head Neck 34: 23-33, 2012