OBJECTIVE: To investigate the effectiveness external radiation (XRT) vs transoral laser surgery (TOL) for treatment of early glottic carcinoma. METHOD: Medline (1990-2010), Embase (1990-2010), Cochrane Library, CBM (1990-2010), CNKI (1994-2010), Wanfang Database were searched for published case-control studies investigating the effectiveness external radiation vs transoral laser surgery for treatment of early glottic carcinoma. The odds ratio was calculated. Meta-analyses were performed by RevMan5. 0. 2 Software. RESULT: In the complications of this study, there was significant heterogeneity in the literatures, so Meta analysis was given up. In the recurrence and 5-years locoregional control, XRT group was no significant difference with TOL group by eliminating the heterogeneity or using the subgroup analysis, but the results till showed there was less recurrence and more locoregional control in TOL group than those in XRT group. In death of disease, overall survival and laryngeal preservation, the differences were statistically significant. CONCLUSIONS TOL could be complete in the clinic and the cost was much more cheaper than XRT. So TOL could be used as the first choice for the treatment of early glottic carcinoma versus XRT. But for larger tumors, involving the anterior commissure, there was no clear conclusion. Based on literatures, traditional surgery was the proposed choice. We recognize that the datas included in our study are retrospective studies, for a more scientific conclusion, we need more RCTs.
Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; radiotherapy ; surgery ; Laser Therapy ; Treatment Outcome