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Background: Vocal problems caused by Chemo-radiation therapy (CRT) can affect a patient’s quality of life (QOL) for a long time. This study aims to follow up and evaluate the voice of Persian-speaking patients with non-laryngeal head and neck cancer up to eighteen months after treatment. Material and Methods: This prospective study was conducted to assess the voice of disease-free patients with various head and neck malignancies treated with CRT. The voice assessment was conducted at four points: before, at the end of treatment, and six and eighteen months after treatment. At the time of the last assessment, there were only 30 patients with an average age of 48.86 ą14. 89 and in the range of (18-75) years. For a comprehensive assessment, acoustic, expert-rater, and subjective evaluation of voice was conducted. The Pearson correlation coefficient for all acoustic parameters, subgroups of the Persian VHI-30 questionnaire, and perceptual measurements were computed. The effect of essential factors on patient QOL associated with the voice in different groups was examined.

Results: All acoustic parameters, other than fundamental and habitual frequencies, subjective and perceptual data values increased significantly (P< 0.001) during the treatment and decreased at the last assessment. None of the values have returned to pre-treatment levels. There was a significant relationship between some acoustic parameters, Persian VHI-30 questionnaire values, and G on the GRBAS scale. Chemotherapy and smoking were influential factors in patients' QOL. Conclusions: Vocal problems and reduced voice related QOL in patients treated with …