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Is CO2 laser microsurgery better than radiotherapy in early glottic cancer: a meta-analysis.

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Title: Is CO2 laser microsurgery better than radiotherapy in early glottic cancer: a meta-analysis.
Authors: Yang, Yong1,2 (AUTHOR), Wang, Yong-li1 (AUTHOR), Wei, Li-zhi2 (AUTHOR), Wang, Ju-xin2 (AUTHOR), Huang, Fang-ting2 (AUTHOR), Huang, Guang-wu1 (AUTHOR) hgw1288@126.com
Source: Lasers in Medical Science. 9/27/2023, Vol. 38 Issue 1, p1-12. 12p.
Subjects: Secondary primary cancer, Microsurgery, Laser surgery, Lasers, Radiotherapy
Abstract: The choice between radiotherapy (RT) and CO2 laser surgery (CO2-LS) for early glottic cancer remains controversial. We systematically examined electronic databases in order to identify prospective trials comparing patients who had undergone CO2-LS or RT to treat early glottic cancer. Eleven studies involving 1053 patients were included. In the selected literature, the parameter setting of CO2 laser equipment can be summarized as wavelength 10.6 µm, superpulsed mode, continuous setting, power tailored on target structures (1–3 W for subtle resections and 4–15 W for cutting a larger tumor), and approximately 2080–3900 W/cm2 of laser energy. Using RevMan 5.3, we estimated pooled odds ratios (ORs) for dichotomous variables and pooled mean differences (MDs) for continuous variables, along with associated 95% confidence intervals (CIs). The heterogeneity in the treatment variables was measured using Higgins' inconsistency test and expressed as I2 values. The continuous variables were then depicted as histograms developed using PlotDigitizer 2.6.8. Compared to patients treated with CO2-LS, those treated with RT had better jitter (MD 1.27%, 95% CI 1.21 ~ 1.32, P < 0.001), and high scores on the "Grade (MD 6.54, 95% CI 5.31 ~ 7.76, P < 0.001), Breathiness (MD 9.08, 95% CI 4.02 ~ 14.13, P < 0.001), Asthenia (MD 2.13, 95% CI 0.29 ~ 3.98, P = 0.02), and Strain (MD 3.32, 95% CI 0.57 ~ 6.07, P = 0.02)" scale. Patients treated with CO2-LS had worse local control rates (OR 3.14, 95% CI 1.52 ~ 6.48, P = 0.002) while lower incidence of second primary tumor (OR 0.30, 95% CI 0.15 ~ 0.61, P < 0.001). It is hoped that retrospective analysis can provide suggestions for early glottis patients to choose personalized treatment. [ABSTRACT FROM AUTHOR]
Copyright of Lasers in Medical Science is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
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  Data: Is CO&lt;subscript&gt;2&lt;/subscript&gt; laser microsurgery better than radiotherapy in early glottic cancer: a meta-analysis.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Yang%2C+Yong%22&quot;&gt;Yang, Yong&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Wang%2C+Yong-li%22&quot;&gt;Wang, Yong-li&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Wei%2C+Li-zhi%22&quot;&gt;Wei, Li-zhi&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Wang%2C+Ju-xin%22&quot;&gt;Wang, Ju-xin&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Huang%2C+Fang-ting%22&quot;&gt;Huang, Fang-ting&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Huang%2C+Guang-wu%22&quot;&gt;Huang, Guang-wu&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; hgw1288@126.com&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Lasers+in+Medical+Science%22&quot;&gt;Lasers in Medical Science&lt;/searchLink&gt;. 9/27/2023, Vol. 38 Issue 1, p1-12. 12p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Secondary+primary+cancer%22&quot;&gt;Secondary primary cancer&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Microsurgery%22&quot;&gt;Microsurgery&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Laser+surgery%22&quot;&gt;Laser surgery&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Lasers%22&quot;&gt;Lasers&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Radiotherapy%22&quot;&gt;Radiotherapy&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: The choice between radiotherapy (RT) and CO2 laser surgery (CO2-LS) for early glottic cancer remains controversial. We systematically examined electronic databases in order to identify prospective trials comparing patients who had undergone CO2-LS or RT to treat early glottic cancer. Eleven studies involving 1053 patients were included. In the selected literature, the parameter setting of CO2 laser equipment can be summarized as wavelength 10.6 &#181;m, superpulsed mode, continuous setting, power tailored on target structures (1–3 W for subtle resections and 4–15 W for cutting a larger tumor), and approximately 2080–3900 W/cm2 of laser energy. Using RevMan 5.3, we estimated pooled odds ratios (ORs) for dichotomous variables and pooled mean differences (MDs) for continuous variables, along with associated 95% confidence intervals (CIs). The heterogeneity in the treatment variables was measured using Higgins&#39; inconsistency test and expressed as I2 values. The continuous variables were then depicted as histograms developed using PlotDigitizer 2.6.8. Compared to patients treated with CO2-LS, those treated with RT had better jitter (MD 1.27%, 95% CI 1.21 ~ 1.32, P &lt; 0.001), and high scores on the &quot;Grade (MD 6.54, 95% CI 5.31 ~ 7.76, P &lt; 0.001), Breathiness (MD 9.08, 95% CI 4.02 ~ 14.13, P &lt; 0.001), Asthenia (MD 2.13, 95% CI 0.29 ~ 3.98, P = 0.02), and Strain (MD 3.32, 95% CI 0.57 ~ 6.07, P = 0.02)&quot; scale. Patients treated with CO2-LS had worse local control rates (OR 3.14, 95% CI 1.52 ~ 6.48, P = 0.002) while lower incidence of second primary tumor (OR 0.30, 95% CI 0.15 ~ 0.61, P &lt; 0.001). It is hoped that retrospective analysis can provide suggestions for early glottis patients to choose personalized treatment. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Lasers in Medical Science is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s10103-023-03890-3
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      – Code: eng
        Text: English
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    Subjects:
      – SubjectFull: Secondary primary cancer
        Type: general
      – SubjectFull: Microsurgery
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      – SubjectFull: Laser surgery
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      – SubjectFull: Lasers
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      – SubjectFull: Radiotherapy
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      – TitleFull: Is CO2 laser microsurgery better than radiotherapy in early glottic cancer: a meta-analysis.
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              M: 09
              Text: 9/27/2023
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              Y: 2023
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