Carbon Dioxide Laser Microsurgery versus Low-Temperature Plasma Radiofrequency Ablation for T1a Glottic Cancer: A Single-Blind Randomized Clinical Trial

Abstract EN

Background.

Very few studies have been conducted to compare carbon dioxide laser microsurgery (CO2-LS) with low-temperature plasma radiofrequency ablation (LTP-RFA) in treating T1a glottic cancer.

Therefore, we conducted this study to compare the efficacy of CO2-LS and LTP-RFA to define a superior therapeutic modality for T1a glottic cancer.

Methods.

Patients (n=131) with T1a glottic cancer were recruited between January 2010 and September 2014.

The included patients were randomly assigned to either receive CO2-LS (n=65) or LTP-RFA (n=66).

We conducted the following multidimensional vocal assessments: (i) videostroboscopic evaluation; (ii) auditory-perceptual evaluation; (iii) aerodynamics/ efficiency; (iv) acoustics; and (v) self-assessment questionnaires.

Meanwhile, the surgery time and three-year overall survival rates in two groups were recorded.

The predefined primary endpoint was overall survival, and the minimum follow-up time was set to six months.

Results.

After treatment, we found that the structure and vibration of vocal cord might recover more quickly in patients receiving LTP-RFA than in patients receiving CO2-LS, and moreover, the patients in the LTP-RFA group had the better vocal functions.

Meanwhile, the surgery time was significantly less in the LTP-RFA group (8.83±1.59 minutes) than in the CO2-LS group (12.49±1.40 minutes) (p<0.00001).

In addition, the two intervention methods had the similar three-year overall survival rates (94% versus 96%, p=0.58).

Conclusion.

These results indicated that both LTP-RFA and CO2-LS could effectively treat T1a glottic cancer, and LTP-RFA might have some advantages in voice function.

Limited by the relatively small sample size, future studies were needed to validate our conclusion.