Academic Radiation Oncology, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK.
Radiother Oncol. 2010 Nov;97(2):270-5. doi: 10.1016/j.radonc.2010.01.017. Epub 2010 Jun 14.
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 3 years and 72 completed EORTC QLQ-H&N35 questionnaires at 2 years post-radiotherapy.
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.
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.
患者在毒性报告中的作用日益得到认可，但需要对毒性报告工具进行调整和验证，以使其适用于患者使用，因为大多数毒性量表都是为医生设计的。记录放疗相关迟发性毒性很重要，需要加以改进。使用 LENT-SOMA 对晚期治疗效果进行患者评分的症状问卷与公认的生活质量工具（EORTC QLQ-C30/H&N35）进行了比较。
材料/方法：前瞻性地让 220 名头颈部癌症患者在 3 年内完成 LENT-SOMA 和 EORTC QLQ-C30 患者问卷，72 名患者在放疗后 2 年内完成 EORTC QLQ-H&N35 问卷。
对两个问卷的共同终点（疼痛、吞咽困难、牙痛、口干、张口、止痛药）进行匹配。除止痛药外，所有“匹配”量表均获得了 ρ>0.6（P<0.001）的 Spearman 秩相关系数。LENT-SOMA 与 EORTC QLQ-H&N35 之间除了止痛药终点外，具有良好的一致性。总体生活质量评分与平均 LENT-SOMA 评分呈负相关（P<0.001）。不同治疗方式之间的平均 LENT-SOMA 评分存在显著差异。LENT-SOMA 问卷的 Cronbach's α 值为 0.786，表明其可靠性较高。
在可以明确比较的毒性项目中，LENT-SOMA 患者问卷的结果与 EORTC QLQ-H&N35 问卷的结果非常吻合，尤其是对于主观终点。患者报告的迟发性毒性对生活质量有负面影响。LENT-SOMA 患者问卷既可靠又能敏感地区分不同治疗方式的患者之间的差异。基于患者的问卷是捕捉放疗后晚期效应的重要贡献者。
