Development of an oral assessment tool to evaluate appetite in patients with head and neck cancer receiving radiotherapy.

PURPOSE: The objective of this study was to develop an oral assessment tool for evaluating the appetite of patients with head and neck cancer receiving radiotherapy, who had dysgeusia, xerostomia, and oral mucositis, as well as to verify its validity and reliability. METHODS AND SAMPLE: A draft oral assessment tool, which included a 5-point scale and 19 items, was prepared based on an interview survey of 30 patients. The resultant questionnaire survey was provided to 209 subjects. RESULTS: On the basis of factor analysis of construct validity, 3 factors (dysgeusia and loss of favors), (salivation abnormality and loss of moisture in the oral cavity), and (pain in the oral cavity and lack of motivation) comprising 14 items were adopted for the final survey. During a review of criteria validity, a correlation was found between the scores of the three factors and overall oral assessment tool, and the scores of taste sensitivity, xerostomia, oral mucositis, and appetite with a correlation coefficient of r = 0.41-0.89 (p < 0.01). With regard to reliability, stability was determined as 0.87 (p < 0.01) according to test-retest study results. Internal consistency was confirmed by a Cronbach's alpha coefficient of 0.83 (p < 0.01) and an interclass correlation coefficient of 0.80 (p < 0.01). CONCLUSIONS: On the basis of the validity and reliability of the oral assessment tool developed, it has been found to be practical for use in the assessment of appetite of patients with head and neck cancer.

Acute radiation toxicity assessment of a 3-D conformal head and neck radiation treatment technique.

Patients undergoing radiation treatment for head and neck cancer have many critical structures within or adjacent to the treatment area. Avoiding these critical structures is more efficient and easier using 3-D conformal planning. At Sir Charles Gairdner Hospital an investigation into the acute radiation toxicity was undertaken when the head and neck treatment technique was changed from the conventional 2-D plan to the conformal 3-D plan. Although the primary target volume (PTV), fraction size and overall dose remain the same for the two techniques, differing beam configurations mean that treatment fields enter and exit through different parts of the head and neck. Ten patients were initially assessed to gain a baseline appearance of their head and neck region, and then graded weekly according to the toxicity criteria during treatment and at 4, 8 and 12 weeks after treatment. The results of the assessment indicate that there is no increase in toxicity as a result of treating using the conformal head and neck technique.