Development and Validation of a Rapid Screening Measure for Mask Anxiety in Head and Neck Cancer Patients Undergoing Radiotherapy.

Abstract

ObjectiveThis study aims to develop a brief screening questionnaire for early identification of radiotherapy mask-related anxiety in patients with head and neck cancer.MethodsA cross-sectional study recruited 512 patients undergoing radiotherapy between April 2016 and February 2021. Participants completed a screening questionnaire assessing mask-related anxiety and were assessed for anxious response during CT or MRI planning scans. A subgroup completed the Claustrophobia Questionnaire (CLQ) for comparison. Data were analyzed using multivariate logistic regression and discriminant validity was evaluated using the area under the ROC curve (AUROC).ResultsThe study developed the Radiotherapy Mask Anxiety Questionnaire (R-MAQ), consisting of four items, derived from the screening questionnaire, which showed good model fit (Hosmer-Lemeshow p = 0.92) and predictive accuracy (AUROC = 0.78). Of the 410 participants (mean age 62), 27.3% presented an anxious response to the immobilization mask during planning exams. The R-MAQ demonstrated comparable or superior validity to the CLQ and effectively identified patients at risk of radiotherapy mask-related anxiety.ConclusionsThe R-MAQ is a valid and efficient tool for identifying patients at risk of mask-related anxiety during radiotherapy for head and neck cancer. It offers a clinically relevant, context-specific method for early intervention, potentially improving treatment adherence and outcomes. Future research should explore its broader applicability and impact on treatment efficacy.