Prospective evaluation of patient reported swallow function with the Functional Assessment of Cancer Therapy (FACT), MD Anderson Dysphagia Inventory (MDADI) and the Sydney Swallow Questionnaire (SSQ) in head and neck cancer patients. (September 2018)

• Record Type: Journal Article
• Authors: Peng, Luke C.; Hui, Xuan; Cheng, Zhi; Bowers, Michael R.; Moore, Joseph; Cecil, Emilie; Choflet, Amanda; Thompson, Alex; Muse, Mariah; Kiess, Ana P.; Page, Brandi R.; Gourin, Christine G.; Fakhry, Carole; Szczesniak, Michal; Maclean, Julia; Wu, Peter; Cook, Ian; McNutt, Todd R.; Quon, Harry
• Is Part Of: Oral oncology. Volume 84(2018)
• Page Start: 25
• Page End: 30
• Publication Date: 2018-09
• Subjects: Head and neck cancer -- Radiotherapy -- Quality of life -- Patient reported outcomes -- Surveys and questionnaires -- Dysphagia -- Adverse effects -- Otorhinolaryngologic surgical procedures; PRO patient reported outcome -- QoL quality of life -- HNC head and neck cancer -- MDADI MD Anderson Dysphagia Inventory -- SSQ Sydney Swallow Questionnaire -- FACT Functional Assessment of Cancer Therapy -- FACT-G Functional Assessment of Cancer Therapy – General -- FACT-HN Functional Assessment of Cancer Therapy – Head and Neck -- FACT-HNSI FACT-HNSI, Functional Assessment of Cancer Therapy – Head and Neck Symptom Index -- FACT-HNCS Functional Assessment of Cancer Therapy – Head and Neck Cancer Subscale -- FACT-PWB FACT-physical well-being domain -- FACT-SWB FACT-social/family well-being domain -- FACT-EWB FACT-emotional well-being domain -- FACT-FWB FACT-functional well-being domain -- ROI region of interest -- PCA principal component analysis -- HNCTD head and neck cancer treatment-related dysphagia -- FEES fiber-optic endoscopic evaluation of swallowing; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2018.05.012
• Languages: English
• ISSNs: 1368-8375

Abstract

Graphical abstract: Highlights: Measuring long term treatment toxicities in Head and Neck Cancer (HNC) is crucial. Common patient reported outcome (PRO) forms include the MDADI, SSQ, and FACT. No universal PRO exists but we show high correlations between some instruments. Clustering and principal component analysis (PCA) reveal 3 distinct toxicity groups. PCA suggests redundancy in MDADI and FACT but complementary data from SSQ. Abstract: Objectives: The Functional Assessment of Cancer Therapy (FACT) instrument is comprised of a group of related and overlapping quality of life (QoL) questionnaires including a core general form, head and neck cancer (HNC)-specific items, and an expert-selected index (FACT-HNSI). Understanding how these relate to more HNC-specific instruments such as the MD Anderson Dysphagia Inventory (MDADI) and Sydney Swallow Questionnaire (SSQ) is vital for guiding their use in clinical trials. Materials and methods: HNC patients concurrently completed MDADI, SSQ, and FACT questionnaires at radiation oncology clinic visits (2015–2016). Spearman correlation coefficients were calculated between each FACT instrument and MDADI or SSQ. Unsupervised k-means cluster analyses were performed to identify clusters of similar QoL responses. Principal component analysis (PCA) identified the degree of variability explained by each instrument. Results: We identified 631 instances (363 patients) where the questionnaires were completed concurrently. Correlations between the various FACT measures and SSQ or MDADI were all significant (p < 0.001), but FACT HNC-specific subscale and FACT-HNSI showed the strongest correlation with MDADI and SSQ. Clustering identified 3 distinct groups of responses when combining instruments either pairwise or three-way. PCA revealed that MDADI and FACT HNC-specific subscale provide similar and likely redundant information. Conclusion: FACT HNC-subscale and FACT-HNSI may be preferable over other FACT measures for use in clinical trials where patient-reported swallow function is evaluated. MDADI and FACT provide similar insights into HNC patient QoL while SSQ provides additional, complementary information which could serve to better stratify patients into groups with high, medium, and low QoL outcomes.