Valid and reliable techniques for measuring fibrosis in patients with head and neck cancer postradiotherapy: A systematic review

Background Fibrosis is a common side effect of radiotherapy for head and neck cancer. Although treatments for fibrosis have been developed, valid and reliable measurement tools are needed to verify their efficacy. The purpose of this review was to identify and appraise tools used to measure head and neck fibrosis. Methods Electronic databases were searched for primary research published through April 2014. Main search terms included head and neck cancer, radiotherapy, fibrosis, validity, and reliability. Methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS‐2). Two blinded raters conducted all assessments. Discrepancies were resolved by consensus. Results The search retrieved 534 unique citations. Nine studies met our inclusion criteria, representing 9 different tools. Only 1 tool was assessed for reliability and validity. QUADAS‐2 revealed that all studies were at risk for bias. Conclusion To date, there are no valid and reliable techniques for measuring fibrosis postradiotherapy for head and neck cancer, especially within the suprahyoid and pharyngeal regions. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2322–E2334, 2016