Acoustic analysis of voice in nonlaryngeal head and neck cancer patients post chemoradiotherapy

Nikhila Radhakrishna, BK Yamini, Amrut Sadashiv Kadam, N Shivashankar, Chendil Vishwanathan, Rajesh Javarappa

Journal of Cancer Research and Therapeutics 2017 13(1):113-117

Background: Concurrent chemoradiotherapy (CCRT) used for definitive management of locally advanced head and neck squamous cell carcinoma (HNSCC) allows organ preservation at the cost of preservation of function. Vocal cords, being within the field of irradiation, undergo acute and chronic changes which adversely impacts the patients' voice. Aims: To assess the acute changes in the acoustic characteristics of voice post-CCRT in patients with nonlaryngeal HNSCC. Materials and Methods: Thirty patients with HNSCC treated with CCRT, a total dose of 66–70 Gy/33–35 fractions at five fractions/week, with weekly cisplatin. Acoustic analysis (AA) and laryngoscopic examination performed at baseline, 6 weeks, and 3 months post-CCRT. Statistical analysis of the parameters using ANOVA and Student's t-test was performed. Results: Of the thirty patients, 26 patients completed CCRT. At 6 weeks post-CCRT, among 14/26 patients, most (11/14 [78.57%]) developed Grade III toxicity. On AA, both increase and decrease in mean F0 from baseline was observed. An increase (P < 0.05) in each, i.e., jitter, shimmer, and noise to harmonics ratio (NHR) were recorded. At 3 months post-CCRT, among 8/14 available, most (6/8 [75%]) showed Grade II toxicity. The mean F0 reduced for both genders; jitter and shimmer, and NHR values maintained an increase (P > 0.05). Conclusions: Periodic AA allows quantification of voice changes and mapping of vocal toxicity induced by CCRT.

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