Systematic review and standardized comparison of health-related quality-of-life instruments available for patients with oral cavity cancer and oropharyngeal cancer

BACKGROUND: To identify HRQoL instruments available for oral cavity cancer (OCC) or oropharyngeal cancer (OC) patients and to summarize the evidence on conceptual model measurement, psychometric and administration properties.

MATERIALS AND METHODS: We searched MEDLINE, CENTRAL, EMBASE, and LILACS until April 2023. We included studies evaluating the concept model measurement, psychometric and administration properties of instruments measuring HRQoL in OCC or OC patients. Two researchers assessed each instrument independently, using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. We calculated the overall and seven attribute-specific scores (range 0-100) using the conceptual and measurement model, reliability, validity, responsiveness, interpretability, burden, and alternative forms.

RESULTS: We included seven instruments across 42 articles. The overall EMPRO score of these instruments varied between 84.1 and 29.3, with five questionnaires exceeding the threshold score of 50.0. The domains of conceptual and measurement model and interpretability performed best, while responsiveness exhibited the lowest performance.

CONCLUSIONS: The findings support the use of EORTC QLQ-H&N43, EORTC QLQ-C30, and EORTC QLQ-OH15 as suitable HRQoL instruments for both cross-sectional or longitudinal studies to measure physical, symptomatic, psychological, or social impacts in patients with OCC or OC. FACT-H&N and UW-QoL were deemed appropriate for evaluating HRQoL in cross-sectional studies in these patients.