Decorticatie met CO₂-laser; een doelmatig alternatief voor radiotherapie in de behandeling van TIa-carcinomen van de glottis

Objective. Given that CO₂-laser decortication and radiotherapy are equally effective in the treatment of TIa glottic carcinomas, to determine which of the two is most efficient with respect to treatment costs. Design. Retrospective analysis. Method. The costs of both treatment modalities from the first visit to the Free University Medical Centre, Amsterdam, the Netherlands, until two years after the start of the treatment were calculated, based on the medical consumption of 89 patients who were treated with curative intent for a TIa glottic carcinoma in the years 1995-1999. Results. The total costs from diagnosis until two years after the start of treatment were € 7,253,- for radiotherapy and € 3,864,- for CO₂-laser decortication. These amounts included the costs of diagnosis and treatment of any recurrence or benign laryngeal disorders occurring within the two-year interval. The difference was statistically significant. Conclusion. Radiotherapy was significantly more expensive than CO₂-laser decortication. Therefore CO₂-laser decortication is an efficient alternative to radiotherapy in the treatment of eligible patients with TIa glottic carcinoma.