Comparison of patient-reported late treatment toxicity (LENT–SOMA) with quality of life (EORTC QLQ-C30 and QLQ-H&N35) assessment after head and neck radiotherapy

Ho, Kean Fatt; Farnell, Damien J.J.; Routledge, Jacqueline A.; Burns, Meriel P.; Sykes, Andrew J.; Slevin, Nick J.; Davidson, Susan E.

doi:10.1016/j.radonc.2010.01.017

« Previous Next »Radiotherapy & Oncology
Volume 97, Issue 2 , Pages 270-275, November 2010

Comparison of patient-reported late treatment toxicity (LENT–SOMA) with quality of life (EORTC QLQ-C30 and QLQ-H&N35) assessment after head and neck radiotherapy

Kean Fatt Ho
- Academic Radiation Oncology, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
- Corresponding author. Address: Academic Radiation Oncology, University of Manchester, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK.
Damien J.J. Farnell
- Academic Radiation Oncology, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
Jacqueline A. Routledge
- Academic Radiation Oncology, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
Meriel P. Burns
- Academic Radiation Oncology, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
Andrew J. Sykes
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
Nick J. Slevin
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
Susan E. Davidson
- Academic Radiation Oncology, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK

Received 28 April 2009; received in revised form 9 December 2009; accepted 29 January 2010. published online 16 June 2010.

Abstract

Purpose

The patient’s role in toxicity reporting is increasingly acknowledged but requires the adaptation and validation of toxicity reporting instruments for patient use as most toxicity scales are designed for physician use. Recording of radiotherapy related late toxicity is important and needs to be improved. A patient-scored symptom questionnaire of late treatment effects using LENT–SOMA was compared with a recognised quality of life tool (EORTC QLQ-C30/H&N35).

Materials/methods

LENT–SOMA and EORTC QLQ-C30 patient questionnaires were prospectively completed by 220 head and neck cancer patients over 3years and 72 completed EORTC QLQ-H&N35 questionnaires at 2years post-radiotherapy.

Results

Endpoints common to both questionnaires (pain, swallowing, dental pain, dry mouth, opening mouth, analgesics) were matched. Spearman rank correlation coefficients with ρ>0.6 (P<0.001) were obtained for all “matched” scales except for analgesics scale, ρ=0.267 (P<0.05). There was good agreement between LENT–SOMA and EORTC QLQ-H&N35 except for analgesic endpoints. Global quality of life scores correlated negatively with average LENT–SOMA scores (P<0.001). Significant differences in average LENT–SOMA scores between treatment modalities were found. The LENT–SOMA questionnaire has demonstrated a high Cronbach’s α value (0.786) indicating good reliability.

Conclusions

LENT–SOMA patient questionnaire results agreed well with those from the EORTC QLQ-H&N35 questionnaire for toxicity items where they could be compared explicitly, particularly for subjective endpoints. Patient-reported late toxicity had a negative impact on quality of life. The LENT-SOMA patient questionnaire is both reliable and sensitive to differences between patients treated with different modalities. A patient-based questionnaire is an important contributor to capturing late radiotherapy effects.

Keywords: Radiotherapy late toxicity, Patient-reported outcomes, Head and neck radiotherapy, Quality of life, LENT–SOMA, CTCAE