Head & Neck Oncology

, 2:32

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Patient reported outcomes in head and neck cancer: selecting instruments for quality of life integration in clinical protocols

  • Augusta P SilveiraAffiliated withOral Anatomy and Oral Histology- Health Sciences Department, Fernando Pessoa UniversityInstitute for Biomedical Sciences Abel Salazar, Porto University, Lg. Prof. Abel Salazar no. 2The Centre of Health Studies and Research of the Coimbra University Email author 
  • , Joaquim GonçalvesAffiliated withMath Department, Polytechnic Institute of Cávado and Ave, Campus do IPCA - Lugar do Aldão Email author 
  • , Teresa SequeiraAffiliated withOral Anatomy and Oral Histology- Health Sciences Department, Fernando Pessoa UniversityInstitute for Molecular and Cell Biology Email author 
  • , Cláudia RibeiroAffiliated withHealth Sciences Department, Portuguese Catholic University, Campus Viseu Estrada da CircunvalaçãoFacultad De Medicina Y Odontologia Rua San Francisco, S/N, Santiago de Compostela University Email author 
  • , Carlos LopesAffiliated withHealth Sciences Department, Institute for Biomedical Sciences Abel Salazar- Porto University Email author 
  • , Eurico MonteiroAffiliated withFernando Pessoa UniversityPortuguese Institute for Oncology - Porto, Otorhinolaringology service (IPO-Porto, ORL). Rua Dr. António Bernardino de Almeida Email author 
  • , Francisco L PimentelAffiliated withAveiro University, Secção Autónoma Ciências da Saúde; Campus Universitário de Santiago, Aveiro, Portugal Infante D. Pedro Hospital, Aveiro Email author 



Health Related Quality of Life has been used in medical research for more than twenty years, being progressively accepted during the last decade as an important patient reported outcome. Considering the multidimensional approach involved in Health Related Quality of Life assessment, instrument applicability and cultural adaptation must be tested for each population. In order to select the most appropriate instrument for Head and Neck cancer patients, two major Health Related Quality of Life specific questionnaires for Head and Neck cancer patients were compared. Conceptual differences, psychometric characteristics, scores, reliability, construct validity and sensitivity to symptomatology, tumour location, tumour size were analyzed.


102 consecutive Head and Neck cancer patients completed two different Health Related Quality of Life questionnaires: EORTC QLQ-C30 and its specific head and neck module QLQ-H&N35 and the Functional Assessment of Cancer Therapy Scales (FACT-H&N). Patients completed the questionnaires, immediately before consultation as a part of the routine evaluation.


A greater variability was always found in the EORTC QLC-C30 questionnaire's scores for all comparable domains. Both instruments revealed a good internal consistency and demonstrated to be good tools to distinguish symptomatic patients. The EORTC questionnaires still demonstrated sensitivity to distinguish T3 and T4 staging. Conceptual differences and the psychometric characteristics are discussed. Our results suggest that these two instruments assess different aspects of Health Related Quality of Life - the questionnaires should be used separately and chosen according to the study objectives and methodology.


This study emphases the importance in selecting the appropriate tool as a critical success factor in implementing routine Health Related Quality of Life assessment in clinical practice. This decision assumes particularly importance when utilization of results in real time and integration into clinical protocols are considered.