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Developing a CTCAEs patient questionnaire for late toxicity after head and neck radiotherapy

Ho, K. F., Farnell, Damian J. J. ORCID: https://orcid.org/0000-0003-0662-1927, Routledge, J. A., Burns, M. P., Sykes, A. J., Slevin, N. J. and Davidson, S. E. 2009. Developing a CTCAEs patient questionnaire for late toxicity after head and neck radiotherapy. European Journal of Cancer 45 (11) , pp. 1992-1998. 10.1016/j.ejca.2009.04.010

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Abstract

Purpose: Patient-based reporting of symptoms is increasingly important in providing treatment toxicity information. However, observer-based scoring systems such as the CTCAEs which incorporate the LENT-SOMA scales are not adapted for patient-based reporting. We aim to (1) report the late toxicity in patients following head and neck radiotherapy using a LENT-SOMA patient-based questionnaire, (2) describe how the responses help to improve the questionnaire and (3) adapt the questionnaire for patient reporting using CTCAEs. Methods: A 31-item LENT-SOMA patient questionnaire was administered prospectively to 220 patients pre-treatment and at eight time periods post-radical head and neck radiotherapy over 3 years. Exploratory factor analysis was carried out and questionnaire reliability was evaluated using Cronbach’s α coefficient. Results: At 3-years follow-up, grade 3/4 toxicity was recorded for xerostomia (44%), hoarseness (14.3%), altered taste (6.1%) and oropharyngeal pain (1.9%). Factor analysis indicated that questionnaire division according to anatomical sub-site was reasonable. Cronbach’s α was 0.851 (95% CI: 0.820–0.883) indicating high reliability. Good compliance was obtained with all questions except for the ‘weight loss’ item. A satisfaction survey showed that the questionnaire was clear and concise. Teeth and mandible sections have been removed. Dietary change due to xerostomia has been incorporated in line with CTCAEs. LENT-SOMA scoring of analgesic needs and dysphagia not described in CTCAEs were found useful and have been retained. Conclusions: The questionnaire has enabled reporting of late toxicity and the responses have enabled refinement of the questionnaire. It is reliable, feasible and has been validated for patient-based collection of CTCAEs late toxicity data.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Dentistry
Publisher: Elsevier
ISSN: 0959-8049
Last Modified: 04 Jan 2024 08:38
URI: https://orca.cardiff.ac.uk/id/eprint/59348

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