Comparison of White Light With Narrow Band Imaging Using Flexible Laryngoscopy for the Detection of Local Recurrences After (Chemo)Radiation for Pharyngeal or Laryngeal Cancer: A Randomised Controlled Trial

Sep 24, 2026

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Early detection of local recurrences in head and neck squamous cell carcinoma (HNSCC) is vital for long-term survival. This prospective randomised controlled trial compared white light (WL) imaging with narrow band imaging (NBI) during flexible laryngoscopy to identify local recurrences and assessed clinical outcomes in HNSCC patients treated with radiotherapy ± chemotherapy ((C)RT). 257 participants without residual disease were followed for 24 months.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

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Introduction

Objectives and study design

Participants and follow-up

Outcomes and results

Conclusions

Clinical Otolaryngology ORIGINAL ARTICLE OPEN ACCESS Comparison of White Light With Narrow Band Imaging Using Flexible Laryngoscopy for the Detection of Local Recurrences After (Chemo)Radiation for Pharyngeal or Laryngeal Cancer: A Randomised Controlled Trial Constanze Scholman1 | Jeroen M. Westra1 | Manon A. Zwakenberg1 | Jan Wedman1 | Bert van der Vegt2 | Roel J. H. M. Steenbakkers3 | Sjoukje F. Oosting4 | Gyorgy B. Halmos1 | Bernard F. A. M. van der Laan1,5 | Boudewijn E. C. Plaat1 1Department of Otorhinolaryngology – Head & Neck Surgery, University of Groningen, University of Medical Center Groningen, Groningen, the Netherlands | 2Department of Pathology and Medical Biology, University of Groningen, University of Medical Center Groningen, Groningen, the Netherlands | 3Department of Radiation Oncology, University of Groningen, University of Medical Center Groningen, Groningen, the Netherlands | 4Department of Medical Oncology, University of Groningen, University of Medical Center Groningen, Groningen, the Netherlands | 5Department of Otorhinolaryngology – Head & Neck Surgery, Haaglanden Medical Center, The Hague, the Netherlands Correspondence: Constanze Scholman ([c.scholman@umcg.nl](c.scholman@umcg.nl)) Received: 19 August 2024 | Accepted: 1 February 2025 Funding: This work was supported by unrestricted research funding by Olympus Medical Systems EU. Keywords: clinical outcome | flexible laryngoscopy | head and neck cancer | narrow band imaging | randomised controlled trial | recurrence ABSTRACT Objectives: Early detection of local recurrences in patients with head and neck squamous cell carcinoma (HNSCC) is crucial for long-term survival. Aim of this study was to compare white light (WL) imaging with narrow band imaging (NBI) during flexible laryngoscopy for detection of local recurrences and evaluate the effects on clinical outcome in patients with HNSCC treated with radiotherapy ± chemotherapy ((C)RT) . Design: Prospective randomised controlled trial. Setting: Tertiary head and neck oncologic center. Participants: 257 patients without residual disease after (C)RT were randomised in a WL group (n = 120) or WL-NBI group (n = 137) and followed for 24 months. Main Outcome Measures: Local recurrence rate and overall survival, disease-specific survival, disease-free survival and local recurrence-free survival were compared between both groups. Results: Detection rate of local recurrences was the same in both groups: 11.7% in WL-NBI and 10.0% in WL (p >0.05) . Overall survival (WL: 88.3%, WL-NBI: 87.6%), disease-specific survival (WL: 86.7%, NBI: 83.9%), disease-free survival (WL: 85.0%, WL-NBI: 83.2%) and local recurrence-free survival (WL: 90.0%, WL-NBI: 89.1%) showed no superiority in the WL-NBI group (p > 0.05) . | Constanze Scholman and Jeroen M. Westra contributed equally to this study.
This article was presented at the AHNS 11th International Conference on Head and Neck Cancer; July 8–12, 2023; Montreal, Canada. | | --- | | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2025 The Author(s). Clinical Otolaryngology published by John Wiley & Sons Ltd. | 664 Clinical Otolaryngology, 2025; 50:664–673 [https://doi.org/10.1111/coa.14293](https://doi.org/10.1111/coa.14293) Conclusions: Local recurrence rates are relatively low in the first 24 months after (C)RT for HNSCC. WL-NBI did not improve the detection of local recurrences nor the survival compared to WL. Trial Registration: This randomised clinical trial was registered at the research register UMCG with the number 201500918 1 | Introduction Early detection of local recurrences or second primary tumours (SPT) in patients with head and neck squamous cell carcinoma (HNSCC) is crucial for long-term survival [1] . The recurrence rate of HNSCC depends on tumour sta

FAQs

What was the study objective in comparing WL with WL-NBI?

To compare white light imaging with narrow band imaging during flexible laryngoscopy for detecting local recurrences and to evaluate effects on clinical outcome in HNSCC patients treated with (C)RT.

How many patients participated and what follow-up duration was used?

A total of 257 patients without residual disease were randomised to WL (n=120) or WL-NBI (n=137) and followed for 24 months.

Did WL-NBI improve detection of local recurrences or survival versus WL?

No. Detection rates were similar (11.7% in WL-NBI vs 10.0% in WL, p>0.05), and overall survival, disease-specific survival, disease-free survival, and local recurrence-free survival showed no superiority for WL-NBI (p>0.05).

Sep 24, 2026

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