ABSTRACT
Xerostomia in head and neck (H&N) cancer patients significantly affects their quality of life (QoL). The aim of the present study was to investigate the associations among QoL, xerostomia and quantity of saliva in a sample of H&N cancer patients who had received conventional radiotherapy (RT). A total of 60 H&N adult patients were enrolled in this prospective study. The patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30), the Quality of Life Questionnaire Head and Neck Module (QLQ-H&N35) and the Greek version of the XQ questionnaire at 4 timepoints: At the beginning of RT, at the end of RT, 6 months after RT completion and 1 year after RT completion. Patients with distant metastases or serious comorbidities were excluded from the study. Salivary pH, and stimulated and unstimulated salivary flow rate were assessed. All functional scales and symptom scales, apart from cognitive functioning in QLQ-C30 and feeding tube in H&N35 exhibited an abrupt deterioration at timepoint 3 and were then gradually restored over time. The difference was statistically significant (P<0.001). XQ scores at different timepoints exhibited a statistically significant negative correlation with salivary flow rates. Salivary flow rate and XQ scores almost parallelled one another. Flow rates recovered at a mean level of 20% below baseline values at the end of the follow-up period. The subjective symptom of xerostomia parallelled salivary flow and QoL. Despite receiving conventional RT, the participants exhibited a considerable preservation of salivary gland function after 12 months, allowing some optimism regarding the course of xerostomia in selected patients.
ABSTRACT
PURPOSE: Xerostomia after radiation therapy for head and neck (H&N) cancer has serious effects on patients' quality of life. The purpose of this study was to validate the Greek version of the self-reported eight-item xerostomia questionnaire (XQ) in patients treated with radiotherapy for H&N cancer. METHODS: The XQ was translated into Greek and administered to 100 XQ patients. An exploratory factor analysis was performed. Reliability measures were calculated. Several types of validity were evaluated. The observer-rated scoring system was also used. RESULTS: The mean XQ value was 41.92 (SD 22.71). Factor analysis revealed the unidimensional nature of the questionnaire. High reliability measures (ICC, Cronbach's α, Pearson coefficients) were obtained. Patients differed statistically significantly in terms of XQ score, depending on the RTOG/EORTC classification. CONCLUSION: The Greek version of XQ is valid and reliable. Its score is well related to observer's findings and it can be used to evaluate the impact of radiation therapy on the subjective feeling of xerostomia.
