title: Quality-of-life measurement in patients undergoing radiation therapy for head and neck cancer: a Hong Kong experience.
abstract: The aims of this study are (1) to establish a reliable and valid quality-of-life (QOL) questionnaire for Chinese patients with head and neck (H&N) cancer who are treated with radiation therapy and (2) to evaluate the impact of the immediate side effects of treatment on the QOL of these patients. The 39-item "Quality of Life Radiation Therapy Instrument with Head and Neck Companion Module" (QOL-RTI/H&N) was translated into Chinese. In the reliability evaluation phase (study module 1), the questionnaire was administered twice to 56 H&N cancer patients, 7 days apart, during the second and third week of radiation therapy. In the validity evaluation phase (study module 2), 138 patients completed the QOL-RTI/H&N before starting and at the end of radiation therapy. Sixty-nine of these 138 patients also completed the QOL-RTI/H&N during the second week of their radiation therapy, at the same time as completing the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) questionnaire. Cronbach alpha coefficients were 0.88 for the general-tool QOL-RTI and 0.90 for the H&N subscale. Test-retest reliability was satisfactory with intraclass correlation coefficients of 0.89 for the general-tool QOL-RTI and 0.75 for the H&N subscale. The instrument can discriminate between patients with stage I or II disease and those with stage III or IV disease (P < .05). Concurrent validity was established by the good agreement with the FACT-H&N (r = 0.86, P < .001). A highly significant deterioration was in the QOL from the baseline to the end of treatment (mean difference for general tool = 1.95, P < .001; mean difference for H&N subscale = 4.85, P < .001). The Chinese QOL-RTI/H&N is a reliable and valid tool for determining the QOL in H&N cancer patients receiving radiation therapy. The immediate side effects of treatment had a significantly negative impact on the patients' QOL. The impact was relatively large for the functional and treatment-site aspects.
authors.affiliation: Division of Otorhinolaryngology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China. sylo@cuhk.edu.hk
authors.forename: Phoebe S Y
authors.initials: PS
authors.lastname: Lo
authors.forename: Sing Kai
authors.initials: SK
authors.lastname: Lo
authors.forename: Michael C F
authors.initials: MC
authors.lastname: Tong
authors.forename: Peter K M
authors.initials: PK
authors.lastname: Ku
authors.forename: Sing Fai
authors.initials: SF
authors.lastname: Leung
authors.forename: C Andrew
authors.initials: CA
authors.lastname: van Hasselt
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology* / Q000532:radiotherapy*; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D011795:Surveys and Questionnaires