Patient-reported quality-of-life outcomes in relation to provider-assessed adverse events during head and neck radiotherapy

Joshua R. Niska, Cameron S. Thorpe, Michele Y. Halyard, Angelina D. Tan, Pamela J. Atherton, Amylou C. Dueck, Samir H. Patel, Jeff A. Sloan

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Purpose: To assess the relationship between patient-reported quality-of-life (QOL) outcomes and provider-assessed adverse events (AEs) during head-and-neck (H&N) radiotherapy (RT). Methods: Sixty-five patients undergoing H&N RT prospectively completed 12-domain linear analogue self-assessments (LASA) at baseline, before biweekly appointments, and at last week of RT. At the same time points, provider-assessed AEs were graded using Common Terminology Criteria for Adverse Events v4.0. LASA scores were stratified by maximum-grade AE and analyzed using Kruskal-Wallis methodology. Agreement between LASA scores and maximum-grade AE was assessed using Bland-Altman analysis. Results: Patient-reported QOL outcomes showed clinically meaningful decreases in most domains, predominantly fatigue (77.8% of patients), social activity (75.4%), and overall QOL (74.2%). Provider-assessed AEs showed 100% grade 2 AE, 35.4% grade 3 AE, and 3.1% grade 4 AE. At baseline, patients with higher grade AEs reported worse physical well-being (WB) (P =.04). At week 1, the following QOL domains were worse for patients with higher grade AEs: overall QOL (P =.03), mental WB (P =.02), and physical WB (P =.03). Bland-Altman analysis showed that QOL scores were relatively worse than AE burden at baseline and relatively better at RT completion. Conclusions: Worse QOL was associated with higher-grade AEs at baseline and early in RT. The impact of AEs on QOL appears to lessen with time. Patient-reported QOL outcomes and provider-assessed AEs provide complementary information.

Original languageEnglish (US)
Article number60
JournalJournal of Patient-Reported Outcomes
Issue number1
StatePublished - Dec 1 2020


  • Cancer
  • Head and neck neoplasms
  • Patient reported outcome measures
  • QOL
  • Quality-of-life
  • RT
  • Radiation oncology
  • Radiation therapy
  • Radiotherapy

ASJC Scopus subject areas

  • Health Informatics
  • Health Information Management


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