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Radiotherapy and surgery for early laryngeal cancer achieve comparably good results in patient survival, and the choice of treatment between them is being influenced increasingly by the expected voice quality and quality of life (QoL). The superiority of vocal function after radiotherapy has been shown in previous objective voice assessment studies. This study compared the QoL of long-term survivors after endoscopic laser surgery or radiotherapy for early laryngeal carcinoma. QoL was evaluated with two validated questionnaires: the global EORTC QLQ-C30 and the head- and neck-specific EORTC QLQ-H&N35. A total of 62 patients were included. Among 56 patients completing the questionnaires (90% completion rate) 40 were treated by endoscopic CO2 laser surgery and 16 with radiation therapy. All 56 patients showed a good global QoL with no significant difference between the two treatment modalities. The head- and neck-specific evaluation revealed significantly better scores for surgically treated patients in questions about swallowing of solid food, xerostomia, and tooth problems, but no difference in questions about voice quality. Both treatment modalities achieve good QoL after treatment of early laryngeal tumors. Irradiated patients mainly complain about xerostomia related problems. In contrast to objective measurements long-term survivors after surgery do not rate their voice poorer than irradiated patients. The EORTC questionnaires are validated and useful tools in assessing QoL and should further be used in prospective trials.

Radiotherapy and surgery for laryngeal cancer achieve comparable results in patient survival. Therefore, the expected quality of life is increasingly influencing the choice of treatment. The aim of this study was to compare the quality of life of patients after surgery or radiotherapy for laryngeal carcinoma. To evaluate quality of life, we used the validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the EORTC Head and Neck module (EORTC QLQ-H&N35). 65 patients who were treated with either radiotherapy or surgery for laryngeal cancer between January 1990 and December 1995, and who were alive and free of tumour in January 1999, were included in this study. In the first group with small tumours (T1/T2), 40 patients were treated by CO2-laser surgery and 16 by primary radiotherapy. In the second group with more advanced tumours (T3/T4), 5 patients underwent total laryngectomy and 4 primary radiotherapy. In the first group there was good global quality of life with no significant difference between the two treatment modalities. Surgically treated patients scored significantly better than the irradiated patients in questions about swallowing of solid food, xerostomia and dental problems. No other significant differences were found: hoarseness in particular was rated equally after both treatments. In the second group there was also good global quality of life with no significant difference between the two treatment modalities. The laryngectomized patients scored equally on questions about voice function, talking on the phone and social behaviour. As far as quality of life is concerned we can recommend both treatment modalities for patients with laryngeal cancer of all stages.