Aims

Patient-reported outcomes measures (PROMs) are an increasingly recognised end point of radiotherapy studies. We hypothesised that the baseline PROMs score is the strongest predictor for acute and late scores after treatment. We assessed the strength of association of baseline MD Anderson Symptom Inventory (MDASI) scores, alongside other known factors for patient- or clinician-reported toxicity, with acute (6-week) and late (12-month) scores in head and neck cancer (HNC) patients following (chemo)radiotherapy.

Materials and methods

This was a retrospective analysis of longitudinal MDASI scores for 247 patients receiving (chemo)radiotherapy for HNC via multivariable linear regression. The factors investigated were: baseline symptom score, age, sex, concurrent chemotherapy, disease stage, radiotherapy fractionation, prior definitive surgery and performance status. Patients with a baseline score >4 in any item were defined as symptomatic in that category.

Results

Patients rated symptomatic for an MDASI item pre-treatment on average reported statistically (P < 0.0005) and clinically (>–1.5) significant reductions in scores 6 weeks and 12 months after (chemo)radiotherapy for all considered sub-items except taste, dryness of mouth and problems with teeth. Conversely patients asymptomatic at baseline reported a worsening of scores at both time points. Other investigated factors showed little association with changes in MDASI scores following treatment.

Conclusions

Our data show that baseline MDASI scores are strongly associated with patient-reported toxicity 6 weeks and 12 months after (chemo)radiotherapy for HNC. Patients who are symptomatic at baseline can experience an early and durable benefit from treatment. This finding can inform discussions with patients before therapy and has implications for use of PROMs scores for the assessment of toxicity in randomised trials.

中文翻译：

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基线 MD Anderson 症状库存评分与患者报告的头颈癌（化疗）放射治疗后的急性和晚期毒性密切相关

目标

患者报告的结果测量 (PROM) 是放射治疗研究中越来越得到认可的终点。我们假设基线 PROMs 评分是治疗后急性和晚期评分的最强预测因子。我们评估了基线 MD Anderson 症状量表 (MDASI) 评分以及其他已知的患者或临床医生报告的毒性因素与头颈癌急性（6 周）和晚期（12 个月）评分的关联强度(HNC) 接受（化学）放射治疗的患者。

材料和方法

这是通过多变量线性回归对 247 名接受（化学）放射治疗的 HNC 患者的纵向 MDASI 评分进行的回顾性分析。调查的因素是：基线症状评分、年龄、性别、同步化疗、疾病分期、放疗分割、既往确定性手术和体能状态。在任何项目中基线评分>4 的患者被定义为该类别中的有症状患者。

结果

对 MDASI 项目治疗前有症状的患者平均报告统计（P < 0.0005）和临床（>–1.5）在（化学）放射治疗后 6 周和 12 个月，除味觉、干燥外的所有考虑的子项目的评分显着降低口腔和牙齿问题。相反，基线时无症状的患者报告在两个时间点的评分都在恶化。其他调查的因素与治疗后 MDASI 评分的变化几乎没有关联。

结论

我们的数据显示基线 MDASI 评分与 HNC（化学）放射治疗后 6 周和 12 个月患者报告的毒性密切相关。基线时有症状的患者可以从治疗中获得早期和持久的益处。这一发现可以为治疗前与患者的讨论提供信息，并对使用 PROMs 评分评估随机试验中的毒性产生影响。