{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T17:27:12Z","timestamp":1786814832797,"version":"build-2736575974"},"reference-count":20,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T00:00:00Z","timestamp":1571356800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_raon-2019-0050_s_007_w2aab3b8b7b1b7b1aab1c16b1Aa\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radiotherapy (RT) is a successful mode of treatment for early glottic cancer. The aim of the study was to assess voice quality both before and 3 months after successful RT using multimodal methods while also identifying the factors affecting it.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_raon-2019-0050_s_008_w2aab3b8b7b1b7b1aab1c16b2Aa\">\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>\n                      In 50 patients with T1 glottic carcinoma, the subjective (patients\u2019 assessment of voice quality [VAS], Voice Handicap Index [VHI] questionnaire, phoniatricians\u2019 assessment using the grade\/roughness\/ breathiness [GRB] scale), and objective assessments (fundamental laryngeal frequency [F\n                      <jats:sub>0<\/jats:sub>\n                      ]\n                      <jats:sub>,<\/jats:sub>\n                      jitter, shimmer, maximum phonation time [MPT]) of voice quality were performed before RT and 3 months post-RT. The data on gender, age, extent of the tumors, biopsy types, smoking, local findings, and RT were obtained from the medical documentation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_raon-2019-0050_s_009_w2aab3b8b7b1b7b1aab1c16b3Aa\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three months after the treatment, VAS, VHI, G and R scores, F\n                      <jats:sub>0<\/jats:sub>\n                      , and MPT significantly improved in comparison with their assessment prior to treatment. Before the treatment, the involvement of the anterior commissure significantly deteriorated jitter (p = 0.044) and the involvement of both vocal folds deteriorated jitter (p = 0.003) and shimmer (p = 0.007). After the RT, F\n                      <jats:sub>0<\/jats:sub>\n                      was significantly higher in the patients with repeated biopsy than in the others (p = 0.047). In patients with post-RT changes, the B score was significantly higher than in those without post-RT changes (p = 0.029).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_raon-2019-0050_s_010_w2aab3b8b7b1b7b1aab1c16b4Aa\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Voice quality already significantly improved three months after the treatment of glottic cancer. The main reason for the decreased voice quality prior to treatment is the tumor\u2019s extent. Post-RT laryngeal changes and repeated biopsies caused more scarring on vocal folds adversely influencing voice quality after the treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/raon-2019-0050","type":"journal-article","created":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T05:02:16Z","timestamp":1571374936000},"page":"459-464","source":"Crossref","is-referenced-by-count":7,"title":["Factors affecting voice quality in early glottic cancer before and after radiotherapy"],"prefix":"10.2478","volume":"53","author":[{"given":"Jana","family":"Mekis","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Primoz","family":"Strojan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ljubljana , Ljubljana , Slovenia"},{"name":"Institute of Oncology Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irena Hocevar","family":"Boltezar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ljubljana , Ljubljana , Slovenia"},{"name":"University Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2019,10,18]]},"reference":[{"key":"2026081517032529556_j_raon-2019-0050_ref_001_w2aab3b8b7b1b7b1ab2ab1Aa","doi-asserted-by":"crossref","unstructured":"Peeters AJ, van Gogh CD, Goor KM, Verdonck-de Leeuw IM, Langendijk JA, Mahieu HF. Health status and voice outcome after treatment for T1a glottic carcinoma. Eur Arch Otorhinolaryngol 2004; 261: 534-40. doi: 10.1007\/ s00405-003-0697-5","DOI":"10.1007\/s00405-003-0697-5"},{"key":"2026081517032529556_j_raon-2019-0050_ref_002_w2aab3b8b7b1b7b1ab2ab2Aa","doi-asserted-by":"crossref","unstructured":"Mendenhall WM, Takes RP, Shah JP, Bradley PJ, Beitler JJ, Strojan P, et al. Current treatment of T1N0 squamous cell carcinoma of the glottic larynx. Eur Arch Otorhinolaryngol 2015; 272: 1821-4. doi: 10.1007\/s00405-014-3388-5","DOI":"10.1007\/s00405-014-3388-5"},{"key":"2026081517032529556_j_raon-2019-0050_ref_003_w2aab3b8b7b1b7b1ab2ab3Aa","doi-asserted-by":"crossref","unstructured":"Agrawal N, Ha PK. Management of early-stage laryngeal cancer. Otolaryngol Clin North Am 2008; 41: 757-69. doi: 10.1016\/j.otc.2008.01.014","DOI":"10.1016\/j.otc.2008.01.014"},{"key":"2026081517032529556_j_raon-2019-0050_ref_004_w2aab3b8b7b1b7b1ab2ab4Aa","doi-asserted-by":"crossref","unstructured":"Huang G, Luo M, Zhang J, Liu H. The voice quality after laser surgery versus radiotherapy of T1a glottic carcinoma: systematic review and meta-analysis. Onco Targets Ther 2017; 10: 2403-10. doi: 10.2147\/OTT.S137210","DOI":"10.2147\/OTT.S137210"},{"key":"2026081517032529556_j_raon-2019-0050_ref_005_w2aab3b8b7b1b7b1ab2ab5Aa","doi-asserted-by":"crossref","unstructured":"Lee SH, Hong KH, Kim JS, Hong YT. Perceptual and acoustic outcomes of early-stage glottic cancer after laser surgery or radiotherapy. A meta-analysis. Clin Exp Otorhinolaryngol 2019; 12: 241-8. doi: 10.21053\/ceo.2018.00990","DOI":"10.21053\/ceo.2018.00990"},{"key":"2026081517032529556_j_raon-2019-0050_ref_006_w2aab3b8b7b1b7b1ab2ab6Aa","unstructured":"Aronson AE. Clinical voice disorders. An interdisciplinary approach 3rd Edition. New York: Thieme Inc.; 1990."},{"key":"2026081517032529556_j_raon-2019-0050_ref_007_w2aab3b8b7b1b7b1ab2ab7Aa","doi-asserted-by":"crossref","unstructured":"Hocevar-Boltezar I, Zargi M, Strojan P. Risk factors for voice quality after radiotherapy for early glottic cancer. Radiother Oncol 2009; 93: 524-9. doi: 10.1016\/j.radonc.2009.09.014","DOI":"10.1016\/j.radonc.2009.09.014"},{"key":"2026081517032529556_j_raon-2019-0050_ref_008_w2aab3b8b7b1b7b1ab2ab8Aa","doi-asserted-by":"crossref","unstructured":"Waghmare CM1, Agarwal J, Bachher GK. Quality of voice after radiotherapy in early vocal cord cancer. Expert Rev Anticancer Ther 2010; 10: 1381-8. doi: 10.1586\/era.10.126","DOI":"10.1586\/era.10.126"},{"key":"2026081517032529556_j_raon-2019-0050_ref_009_w2aab3b8b7b1b7b1ab2ab9Aa","doi-asserted-by":"crossref","unstructured":"Verdonck-de Leeuw IM, Hilgers FJ, Keus RB, Koopmans-van Beinum FJ, Greven AJ, de Jong JM, et al. Multidimensional assessment of voice characteristics after radiotherapy for early glottic cancer. Laryngoscope 1999; 109: 241-8. doi: 10.1097\/00005537-199902000-00014","DOI":"10.1097\/00005537-199902000-00014"},{"key":"2026081517032529556_j_raon-2019-0050_ref_010_w2aab3b8b7b1b7b1ab2ac10Aa","doi-asserted-by":"crossref","unstructured":"Al-Mamgani A, van Rooij PH, Woutersen DP, Mehilal R, Tans L, Monserez D, et al. Radiotherapy for T1-2N0 glottic cancer: a multivariate analysis of predictive factors for the long-term outcome in 1050 patients and a prospective assessment of quality of life and voice handicap index in a subset of 233 patients. Clin Otolaryngol 2013; 38: 306-12. doi: 10.1111\/coa.12139","DOI":"10.1111\/coa.12139"},{"key":"2026081517032529556_j_raon-2019-0050_ref_011_w2aab3b8b7b1b7b1ab2ac11Aa","doi-asserted-by":"crossref","unstructured":"Barsties B, De Bodt M. Assessment of voice quality: Current state-of-the-art. Auris Nasus Larynx 2015; 42: 183-8. doi: 10.1016\/j.anl.2014.11.001","DOI":"10.1016\/j.anl.2014.11.001"},{"key":"2026081517032529556_j_raon-2019-0050_ref_012_w2aab3b8b7b1b7b1ab2ac12Aa","doi-asserted-by":"crossref","unstructured":"Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS, et al. The voice handicap index (VHI): development and validation. Am J Speech Lang Pathol 1997; 6: 66-70. doi: 10.1044\/1058-0360.0603.66","DOI":"10.1044\/1058-0360.0603.66"},{"key":"2026081517032529556_j_raon-2019-0050_ref_013_w2aab3b8b7b1b7b1ab2ac13Aa","doi-asserted-by":"crossref","unstructured":"Tafiadis D, Chronopoulos SK, Helidoni ME, Kosma EI, Voniati L, Papadopoulos P, et al. Checking for voice disorders without clinical intervention: The Greek and global VHI thresholds for voice disordered patients. Sci Rep 2019; 9: 9366. doi: 10.1038\/s41598-019-45758-z","DOI":"10.1038\/s41598-019-45758-z"},{"key":"2026081517032529556_j_raon-2019-0050_ref_014_w2aab3b8b7b1b7b1ab2ac14Aa","doi-asserted-by":"crossref","unstructured":"Alexander FW. Micropathology of radiation reaction in the larynx. Ann Otol Rhinol Laryngol 1963; 72: 831-41. doi: 10.1177\/000348946307200316","DOI":"10.1177\/000348946307200316"},{"key":"2026081517032529556_j_raon-2019-0050_ref_015_w2aab3b8b7b1b7b1ab2ac15Aa","doi-asserted-by":"crossref","unstructured":"Tedla M, Valach M, Carrau RL, Varga I, Profant M, Mr\u00e1z P, et al. Impact of radiotherapy on laryngeal intrinsic muscles. Eur Arch Otorhinolaryngol 2012; 269: 953-8. doi: 10.1007\/s00405-011-1686-8","DOI":"10.1007\/s00405-011-1686-8"},{"key":"2026081517032529556_j_raon-2019-0050_ref_016_w2aab3b8b7b1b7b1ab2ac16Aa","doi-asserted-by":"crossref","unstructured":"Rubin P, Casarett GW. Clinical radiation pathology Philadelphia: W.B. Saunders Company; 1968. p. 36-61.","DOI":"10.2307\/3572601"},{"key":"2026081517032529556_j_raon-2019-0050_ref_017_w2aab3b8b7b1b7b1ab2ac17Aa","doi-asserted-by":"crossref","unstructured":"Marciscano AE, Charu V, Starmer HM, Best SR, Quon H, Hillel AT, et al. Evaluating post radiotherapy laryngeal function with laryngeal videostroboscopy in early stage glottic cancer. Front Oncol 2017; 7: 124. doi: 10.3389\/ fonc.2017.00124","DOI":"10.3389\/fonc.2017.00124"},{"key":"2026081517032529556_j_raon-2019-0050_ref_018_w2aab3b8b7b1b7b1ab2ac18Aa","unstructured":"Colton RH, Casper JK. Understanding voice problems. A physiological perspective for diagnosis and treatment. Fourth Edition. Baltimore: Lippincott, Williams and Wilkins; 2006."},{"key":"2026081517032529556_j_raon-2019-0050_ref_019_w2aab3b8b7b1b7b1ab2ac19Aa","doi-asserted-by":"crossref","unstructured":"Lombardo N, Aragona T, Alsayyad S, Pelaia G, Terracciano R, Savino R. Objective and self-evaluation voice analysis after transoral laser cordectomy and radiotherapy in T1a-T1b glottic cancer. Lasers Med Sci 2018; 33: 141-7. doi: 10.1007\/s10103-017-2361-0","DOI":"10.1007\/s10103-017-2361-0"},{"key":"2026081517032529556_j_raon-2019-0050_ref_020_w2aab3b8b7b1b7b1ab2ac20Aa","doi-asserted-by":"crossref","unstructured":"Van Gogh CD, Verdonck-de Leeuw IM, Wedler-Peeters J, Langedijk JA, Mahieu HF. Perspective evaluation of voice outcome during the first two years in male patients treated by radiotherapy or laser surgery for T1a glottis carcinoma. Eur Arch Otorhinolaryngol 2012; 269: 1647-52. doi: 10.1007\/ s00405-012-1947-1","DOI":"10.1007\/s00405-012-1947-1"}],"container-title":["Radiology and Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/content.sciendo.com\/view\/journals\/raon\/53\/4\/article-p459.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/raon-2019-0050","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T17:03:34Z","timestamp":1786813414000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/raon-2019-0050"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,18]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,10,18]]},"published-print":{"date-parts":[[2019,10,18]]}},"alternative-id":["10.2478\/raon-2019-0050"],"URL":"https:\/\/doi.org\/10.2478\/raon-2019-0050","relation":{},"ISSN":["1581-3207"],"issn-type":[{"value":"1581-3207","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,18]]}}}