Oral-Functioning Questionnaires in Patients with Head and Neck Cancer: A Scoping Review

Background: Oral-functioning impairment can negatively affect the quality of life (QoL) of head and neck cancer (HNC) patients after receiving radiotherapy (RT). Assessment of patient-reported oral functioning throughout treatment can improve patient care. This scoping review aims to propose a definition for oral functioning for HNC patients and to map out the available questionnaires measuring patient-reported oral functioning in RT-treated HNC patients. Methods: A literature search in relevant databases was performed. Each questionnaire was scored on the domains validity, reliability, and responsiveness. Furthermore, the items from the questionnaires were analyzed to define the common denominators for oral functioning in HNC patients. Results: Of the 6434 articles assessed, 16 met the inclusion criteria and employed 16 distinct instruments to evaluate QoL. No questionnaire covered all oral-health-related QoL items nor assessed all aspects of validity, reliability, and responsiveness. Chewing, speaking, and swallowing were the common denominators for oral functioning. Conclusions: Based on the included studies, we suggest using the VHNSS 2.0 questionnaire to assess oral functioning in HNC patients. Furthermore, we suggest to more clearly define oral functioning in HNC patients by focusing on masticatory function (chewing and grinding), mouth opening, swallowing, speaking, and salivation.

[1]  Charters Emma,et al.  Utility of an Oral Competence Questionnaire for Patients with Facial Nerve Paralysis , 2022, Journal of Plastic, Reconstructive & Aesthetic Surgery.

[2]  F. Leusink,et al.  Immediate dental implant placement and restoration in the edentulous mandible in head and neck cancer patients: a systematic review and meta-analysis , 2020, Current opinion in otolaryngology & head and neck surgery.

[3]  I. Brook.  Late side effects of radiation treatment for head and neck cancer , 2020, Radiation oncology journal.

[4]  L. E. Volpato,et al.  Head and Neck Cancer Patients’ Quality of Life: Analysis of Three Instruments , 2020, Journal of dentistry.

[5]  Shu-Ching Chen.  Oral Dysfunction in Patients With Head and Neck Cancer: A Systematic Review. , 2019, The journal of nursing research : JNR.

[6]  Enyan Yu,et al.  Radiotherapy-related quality of life in patients with head and neck cancers: a meta-analysis , 2019, Supportive Care in Cancer.

[7]  J. López‐López,et al.  Quality of life related to oral health and its impact in adults. , 2019, Journal of stomatology, oral and maxillofacial surgery.

[8]  N. Yarom,et al.  International validation of the revised European Organisation for Research and Treatment of Cancer Head and Neck Cancer Module, the EORTC QLQ‐HN43: Phase IV , 2019, Head & neck.

[9]  M. Naito,et al.  To what extent does the EQ-5D-3L correlate with the FACT-H&N of patients with oral cancer during the perioperative period? , 2018, International Journal of Clinical Oncology.

[10]  Yutaka Watanabe,et al.  Oral hypofunction in the older population: Position paper of the Japanese Society of Gerodontology in 2016. , 2018, Gerodontology.

[11]  N. Heaivilin,et al.  Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis , 2017, Cancer medicine.

[12]  A. Yap,et al.  Oral Health Equals Total Health: A Brief Review , 2017 .

[13]  Avraham Eisbruch,et al.  IMRT for head and neck cancer: reducing xerostomia and dysphagia , 2016, Journal of radiation research.

[14]  Li-Zhi Liu,et al.  Development and validation of quality of life scale of nasopharyngeal carcinoma patients: the QOL-NPC (version 2) , 2016, Health and Quality of Life Outcomes.

[15]  N. Yarom,et al.  International field testing of the psychometric properties of an EORTC quality of life module for oral health: the EORTC QLQ-OH15 , 2016, Supportive Care in Cancer.

[16]  Moors Pieter,et al.  Test-retest reliability. , 2014 .

[17]  B. Murphy,et al.  Associations of oral health items of the Vanderbilt Head and Neck Symptom Survey with a dental health assessment. , 2014, Oral oncology.

[18]  L. Stassen,et al.  The dentist's role within the multi-disciplinary team maintaining quality of life for oral cancer patients in light of recent advances in radiotherapy. , 2013, Journal of the Irish Dental Association.

[19]  Sébastien Montel,et al.  The EORTC QLQ-OH17: a supplementary module to the EORTC QLQ-C30 for assessment of oral health and quality of life in cancer patients. , 2012, European journal of cancer.

[20]  A. Cmelak,et al.  Vanderbilt head and neck symptom survey version 2.0: Report of the development and initial testing of a subscale for assessment of oral health , 2012, Head & neck.

[21]  Yena Song,et al.  Effect of questionnaire length, personalisation and reminder type on response rate to a complex postal survey: randomised controlled trial , 2011, BMC medical research methodology.

[22]  A. Vissink,et al.  The Groningen Radiotherapy-Induced Xerostomia questionnaire: development and validation of a new questionnaire. , 2010, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[23]  S. Rogers,et al.  The responsiveness of the Liverpool Oral Rehabilitation Questionnaire (LORQ): a pilot study. , 2009, The International journal of prosthodontics.

[24]  J. Netterville,et al.  Reliability and validity of the Vanderbilt Head and Neck Symptom Survey: A tool to assess symptom burden in patients treated with chemoradiation , 2009, Head & neck.

[25]  D. Moher,et al.  Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement , 2009, BMJ : British Medical Journal.

[26]  Miao-Fen Chen,et al.  Comparison between conventional and intensity-modulated post-operative radiotherapy for stage III and IV oral cavity cancer in terms of treatment results and toxicity. , 2009, Oral oncology.

[27]  Carole L Kimberlin,et al.  Validity and reliability of measurement instruments used in research. , 2008, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[28]  D. Soutar,et al.  The functional intraoral Glasgow scale (FIGS) in retromolar trigone cancer patients. , 2006, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[29]  Robert L. White,et al.  Effect of pilocarpine during radiation therapy: results of RTOG 97-09, a phase III randomized study in head and neck cancer patients. , 2006, The journal of supportive oncology.

[30]  H. Arksey,et al.  Scoping studies: towards a methodological framework , 2005 .

[31]  S. Rogers,et al.  The Liverpool Oral Rehabilitation Questionnaire: a pilot study. , 2004, Journal of oral rehabilitation.

[32]  A. Taylor,et al.  Intensity-modulated radiotherapy—what is it? , 2004, Cancer imaging : the official publication of the International Cancer Imaging Society.

[33]  H. Eriksen,et al.  The human mouth: oral functions in a social complexity perspective , 2003, Acta odontologica Scandinavica.

[34]  C. Gwede,et al.  Complications of Radiation Therapy for Head and Neck Cancers: The Patient’s Perspective , 2002, Cancer nursing.

[35]  S. Rogers,et al.  The addition of mood and anxiety domains to the University of Washington quality of life scale , 2002, Head & neck.

[36]  R. Frankowski,et al.  The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. , 2001, Archives of otolaryngology--head & neck surgery.

[37]  Cynthia Iglesias,et al.  Does Length of Questionnaire Matter? A Randomised Trial of Response Rates to a Mailed Questionnaire , 2000, Journal of health services research & policy.

[38]  G. Slade.  Derivation and validation of a short-form oral health impact profile. , 1997, Community dentistry and oral epidemiology.

[39]  E. Vokes,et al.  The performance status scale for head and neck cancer patients and the functional assessment of cancer therapy‐head and neck scale: A study of utility and validity , 1996, Cancer.

[40]  D. Osoba,et al.  The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. , 1993, Journal of the National Cancer Institute.

[41]  Marshall Godwin,et al.  Health measurement scales , 1991 .

[42]  M. Shuttleworth.  Internal Consistency Reliability , 2022, The SAGE Encyclopedia of Research Design.

[43]  Ralf Dresner,et al.  Health Measurement Scales A Practical Guide To Their Development And Use , 2016 .

[44]  O. John,et al.  The importance of being valid: Reliability and the process of construct validation. , 2007 .

[45]  M. Al Shamrany.  Oral health-related quality of life: a broader perspective. , 2006, Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit.

[46]  C. Gwede,et al.  Development of a head and neck companion module for the quality of life-radiation therapy instrument (QOL-RTI) , 1998, International journal of radiation oncology, biology, physics.

[47]  S. Kaasa,et al.  Development of a European Organization for Research and Treatment of Cancer (EORTC) questionnaire module to be used in quality of life assessments in head and neck cancer patients. EORTC Quality of Life Study Group. , 1994, Acta oncologica.

[48]  A. Kasuya.  EuroQol--a new facility for the measurement of health-related quality of life. , 1990, Health policy.

[49]  D. Lew,et al.  Head and neck cancer patients. , 1989, Journal of the California Dental Association.