Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 8440 112(th) Street Northwest, Edmonton, Alberta T6G 2R7, Canada; Division of Head and Neck Oncology and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond Street, London, Ontario N6A 3K7, Canada.
Division of Head and Neck Oncology and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond Street, London, Ontario N6A 3K7, Canada.
Oral Oncol. 2022 Feb;125:105701. doi: 10.1016/j.oraloncology.2021.105701. Epub 2022 Jan 10.
Malignancy and treatment effects in head and neck oncology can be devastating to functional aspects of patient life such as swallowing, blinking, speech, salivation, and facial expression. Historically, the subjective nature of patient experience has resulted in difficulty with quantification and measurement of functional outcomes. Patient-Reported Outcomes (PROs) are questionnaires developed with patient input, forming the new gold standard for clinician assessment of subjective functional outcomes. The current review aims to identify and characterize the validation of PROs pertaining to four critical functional outcomes in head and neck oncology: swallowing, speech, dry mouth, and chewing. A literature search was conducted using MEDLINE, EMBASE, and the Cochrane databases for published, English language, peer-reviewed abstracts involving patients ≥ 18 years of age. Of 708 results, 705 were excluded at abstract or full text screening for not meeting inclusion criteria, exclusion of head and neck SCC patients in development, or absence of a functional domain measurement. The three reviewed studies-Xerostomia Questionnaire, Swallowing Outcomes After Laryngectomy, and Edmonton 33-exhibited strong reliability and construct and content validity, though two applied only to individual functional outcomes within specific patient populations receiving radiation or laryngectomy. While many PROs have been developed in head and neck oncology, very few properly employed extensive patient input in the development process. Further work must be committed to increasing head and neck cancer patient input in PRO development, particularly in the functional domains of speech and chewing.
头颈部肿瘤的恶性肿瘤和治疗效果可能会对患者生活的功能方面造成严重影响，例如吞咽、眨眼、言语、唾液分泌和面部表情。从历史上看，患者体验的主观性导致功能结果的量化和测量存在困难。患者报告的结果（PROs）是在患者的投入下开发的问卷，成为评估主观功能结果的临床医生的新标准。本综述旨在确定和描述与头颈部肿瘤的四个关键功能结果（吞咽、言语、口干和咀嚼）相关的 PRO 的验证。使用 MEDLINE、EMBASE 和 Cochrane 数据库进行文献检索，以查找涉及≥18 岁患者的已发表的英文同行评审摘要。在 708 项结果中，有 705 项在摘要或全文筛选时被排除，原因是不符合纳入标准、开发过程中排除头颈部 SCC 患者或缺乏功能域测量。综述的三项研究——口干问卷、喉切除术的吞咽结果和埃德蒙顿 33 项——表现出很强的可靠性以及结构和内容有效性，尽管其中两项仅适用于接受放疗或喉切除术的特定患者群体中的个别功能结果。尽管在头颈部肿瘤学中已经开发了许多 PRO，但很少有研究在开发过程中充分利用患者的广泛投入。必须进一步努力增加头颈部癌症患者在 PRO 开发中的投入，特别是在言语和咀嚼的功能领域。
