Validation of the Chinese version of chemotherapy-induced Taste Alteration Scale among patients with head and neck cancer undergoing radiotherapy.

PURPOSE: To validate the Chinese version of the Chemotherapy-induced Taste Alteration Scale (CiTAS) among patients with head and neck cancer (HNC) undergoing radiotherapy (RT). METHODS: Patients with HNC undergoing RT were enrolled from a cancer hospital. Data were collected by face-to-face interview. Patients' subjective taste alterations (TAs) were assessed by the CiTAS. The content validity was evaluated by five experts. Confirmatory and exploratory factor analysis were used to assess construct validity. Convergent validity was assessed by the correlation between the CiTAS score and the Quality of Life Questionnaire-Core 30 (QLQ-C30) score. A single-item subjective intensity taste alteration question and quartiles of RT duration were used to assess the discriminant validity. The reliability was assessed by the Cronbach's alpha and test-retest reliability. RESULTS: 253 patients participated this investigation and 25 patients completed twice. Confirmatory factor analysis showed that the original CiTAS structure with four dimensions was not applicable to patients with HNC undergoing RT. The Chinese version of modified-CiTAS (m-CiTAS) retained 17 items (the item "bothered by the smell of food" was deleted) loading onto three factors: decline in taste, discomfort, and phantogeusia and parageusia. The m-CiTAS showed acceptable correlations with the QLQ-C30. It could effectively discriminate the intensity of subjective TAs according to the single-item question and quartiles of RT duration. The m-CiTAS showed acceptable internal consistency (Cronbach's alpha = 0.573-0.958) and test-retest reliability (r = 0.726-0.831, P < 0.05). CONCLUSIONS: The Chinese version of m-CiTAS is an acceptable and applicable instrument to evaluate TAs among patients with HNC undergoing RT.

Validation of the Chinese version of the Head and Neck Patient Symptom Checklist for measuring nutrition impact symptoms during radiotherapy in patients with head and neck cancer.

PURPOSE: The Head and Neck Patient Symptom Checklist (HNSC) is a valid tool for measuring nutrition impact symptoms (NIS) specific to head and neck cancer (HNC) patients. This study aimed to translate the HNSC into Chinese and to evaluate its psychometric properties in Chinese HNC patients treated with radiotherapy. METHODS: The HNSC was translated into Chinese following standard forward- and back-translation procedures. Three instruments, the Chinese version of HNSC, the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and Patient-Generated Subjective Global Assessment (PG-SGA), were answered by 116 HNC patients, of whom 11 were submitted to the test-retest in 3-7 days. The criterion and convergent validities were confirmed by measuring the relations of the HNSC score with the PG-SGA and EORTC QLQ-C30, respectively. The discriminant validity was evaluated through known group analysis. Reliability was evaluated by means of Cronbach's alpha and test-retest using the correlation coefficient. RESULTS: Criterion validity was 0.767 for intensity dimension and 0.795 for interference dimension, respectively. Convergent validity was confirmed by the significant correlations between the HHSC score and most domains of QLQ-C30. The comparison among the groups demonstrated good discriminant validity. The Cronbach's alpha was 0.787 for intensity dimension and 0.797 for interference dimension, respectively. The test-retest reliability was 0.845 for intensity dimension and 0.883 for interference dimension, respectively. CONCLUSIONS: The Chinese version of HNSC demonstrated favorable validity and reliability. It can be used in identification of NIS and development of symptom management program in HNC patients in China.

Relationship between subjective taste alteration and weight loss in head and neck cancer patients treated with radiotherapy: A longitudinal study.

PURPOSE: To conduct a dynamic and comprehensive evaluation of subjective taste alteration (STA)and identify the association between STA and weight loss in patients with head and neck cancer (HNC) who were treated with radiotherapy. METHODS: STA and weight of 114 patients were recorded at baseline, mid-treatment, post-treatment, and one to two months after radiotherapy (follow-up). Generalized estimating equations (GEE) were used to conduct repeated measures analyses of STA and weight loss at four time-points and assess the relationship between them. RESULTS: The prevalence of STA was 13.2% (baseline), 83.3% (mid-treatment), 92.1% (post-treatment), and 77.9% (follow-up), respectively; the prevalence of ≥10% weight loss increased from 1.8% (mid-treatment) to 44.2% (follow-up). The severity of STA was increasingly poor with radiation therapy and did not return to the baseline level at the follow-up. Meanwhile, the weight of patients did not increase at the follow-up. Among the four subscales of STA (decline in basic taste, general taste alterations, phantogeusia and parageusia, and discomfort), only the discomfort score (ß = -2.988; p = 0.005; 95%confidence interval: -5.084-0.891) had a significant effect on weight loss. CONCLUSIONS: The main finding of this study was that STA, particularly the discomfort symptom associated with dietary intake, as a common and persistent symptom among HNC patients during and after radiotherapy, might promote weight loss in patients, which should be afforded greater attention from medical staff.