The M. D. Anderson symptom inventory-head and neck module, a patient-reported outcome instrument, accurately predicts the severity of radiation-induced mucositis.
OBJECTIVE
To compare the M. D. Anderson Symptom Inventory-Head and Neck (MDASI-HN) module, a symptom burden instrument, with the Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN) module, a quality-of-life instrument, for the assessment of mucositis in patients with head-and-neck cancer treated with radiotherapy and to identify the most distressing symptoms from the patient's perspective.


METHODS
Consecutive patients with head-and-neck cancer (n = 134) completed the MDASI-HN and FACT-HN before radiotherapy (time 1) and after 6 weeks of radiotherapy or chemoradiotherapy (time 2). The mean global and subscale scores for each instrument were compared with the objective mucositis scores determined from the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0.


RESULTS
The global and subscale scores for each instrument showed highly significant changes from time 1 to time 2 and a significant correlation with the objective mucositis scores at time 2. Only the MDASI scores, however, were significant predictors of objective Common Terminology Criteria for Adverse Events mucositis scores on multivariate regression analysis (standardized regression coefficient, 0.355 for the global score and 0.310 for the head-and-neck cancer-specific score). Most of the moderate and severe symptoms associated with mucositis as identified on the MDASI-HN are not present on the FACT-HN.


CONCLUSIONS
Both the MDASI-HN and FACT-HN modules can predict the mucositis scores. However, the MDASI-HN, a symptom burden instrument, was more closely associated with the severity of radiation-induced mucositis than the FACT-HN on multivariate regression analysis. This greater association was most likely related to the inclusion of a greater number of face-valid mucositis-related items in the MDASI-HN compared with the FACT-HN.
Rosenthal
David I
DI
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Mendoza
Tito R
TR
Chambers
Mark S
MS
Burkett
V Shannon
VS
Garden
Adam S
AS
Hessell
Amy C
AC
Lewin
Jan S
JS
Ang
K Kian
KK
Kies
Merrill S
MS
Gning
Ibrahima
I
Wang
Xin S
XS
Cleeland
Charles S
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011832:Radiation Injuries / Q000145:classification*; D011878:Radiotherapy / Q000009:adverse effects*; D012959:Socioeconomic Factors; D013781:Texas; D016896:Treatment Outcome; D044465:White People; D055815:Young Adult; D001741:Black or African American