A Tool for Rapid Assessment of Functional Outcomes in Patients with Head and Neck Cancer

Abstract

Head and neck cancer (HNC) and its treatment can lead to various functional impairments. We developed and validated an instrument for rapid physician-rated assessment of basic functional outcomes in HNC patients. HNC-relevant functional domains were identified through a literature review and assigned to verbal ratings based on observable criteria. The instrument draft was subjected to systematic expert review to assess its face and content validity. Finally, the empirical validity, reliability, and responsiveness of the expert-adapted Functional Integrity in Head and Neck Cancer (HNC-FIT) scales were assessed in healthy controls and in HNC patients. A matrix of the 6 functional domains of oral food intake, respiration, speech, pain, mood, and neck and shoulder mobility was created, each with 5 verbal rating levels. Face and content validity levels of the HNC-FIT scales were judged to be adequate by 17 experts. In 37 control subjects, 24 patients with HNC before treatment, and in 60 HNC patients after treatment, the HNC-FIT ratings in the 3 groups behaved as expected and functional domains correlated closely with the outcome of corresponding scales of the EORTC-HN35-QoL questionnaire, indicating good construct and criterion validity. Interrater reliability (rICC) was ≥0.9 for all functional domains and retest reliability (rICC) was ≥0.93 for all domains except mood (rICC = 0.71). The treatment effect size (eta-square) as a measure of responsiveness was ≥0.15 (p < 0.01) for fall domains except for breathing and neck and shoulder mobility. The median HNC-FIT scale completion time was 1 min 17 s. The HNC-FIT scale is a rapid tool for physician-rated assessment of functional outcomes in HNC patients with good validity, reliability, and responsiveness.

Delayed Reconstruction after Major Head and Neck Cancer Resection: An Interdisciplinary Feasibility Study

“…Functional outcomes were comparable following immediate and delayed reconstruction. The carefully validated HNC-FIT scales were used to assess functional outcome and do not capture detailed specific functions, but rather higher-level functional domains [17]. There were no clinically relevant differences between immediate and delayed reconstruction in any of the six functional domains studied (Table 4).…”

“…The Head and Neck Functional Integrity Scale (HNC-FIT scale) served for rapid clinician-rated assessment of functional status during routine oncologic follow-up [17]. The HNC-FIT scale is a matrix of six verbal rating scales reflecting the functional domains of food intake, respiration, speech, pain, mood, and neck and shoulder mobility.…”

Onkolytische Virotherapie bei Kopf-Hals-Karzinomen

“…In 60 % der Fälle liegt bei Erstdiagnose bereits eine fortgeschrittene Erkrankung vor [2]. Ausgedehnte Tumorresektionen und/oder Radiochemotherapie führen zu erheblichen Einschränkungen der Lebensqualität, insbesondere Störungen der Nahrungsaufnahme, Reduktion der Stimmqualität, Schmerzen und Bewegungseinschränkungen im Kopf-Hals-Bereich [3]. Zusätzlich treten in 15-40 % der Fälle Rezidive und/oder Fernmetastasen auf.…”

“…ICP = Infected Cell Protein, Genprodukte von HSV;2 Evidenzgrade nach[38];3 Coxsackie-Adenovirus-Rezeptor;4 Early-Proteine: werden zu Beginn der viralen Replikation exprimiert; 5 Retinoblastom-Protein; 6 Y-Box-Binding-Protein 1;7 Granulozyten-Makrophagen-Kolonie-stimulierender Faktor;8 Junction Adhesion Molecule 1: Zellmembranprotein, welches als Rezeptor für Reoviren fungiert;9 PFS = progressionsfreies Überleben: die Summe der Patient*innen mit Voll-und Teilremission und stabiler Erkrankung Runge A et al Onkolytische Virotherapie bei… Laryngo-Rhino-Otol | © 2022. Thieme.…”