Online Sharing for Head & Neck Cancer Support

Change in the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) score from baseline to completion of radiotherapy. HADS-A consists of 7 items, each scored 0-3, with total score ranging from 0 to 21. Higher scores indicate more severe anxiety symptoms.

Change in the Hospital Anxiety and Depression Scale-Depression subscale (HADS-D) score from baseline to completion of radiotherapy. HADS-D consists of 7 items, each scored 0-3, with total score ranging from 0 to 21. Higher scores indicate more severe depressive symptoms.

Change in the combined Hospital Anxiety and Depression Scale total score (HADS-A + HADS-D, range 0-42) from baseline to completion of radiotherapy. Higher scores indicate greater overall psychological distress.

Proportion of participants with a combined HADS total score ≥ 15 at radiotherapy completion.

Proportion of participants with unplanned radiotherapy delay of ≥5 days beyond the scheduled treatment period (including weekends and holidays) due to any cause.

Proportion of participants in the intervention group with an average login frequency of >2 times per week during the active intervention period.

The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status/Quality of Life scale consists of two items. Raw scores will be linearly transformed to a 0-to-100 scale according to the EORTC QLQ-C30 scoring manual. Higher scores indicate better global health status and quality of life. Change from baseline will be calculated at each post-baseline assessment, with a positive change indicating improvement.

Head and neck cancer-specific symptoms and problems will be assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Cancer Module (EORTC QLQ-H&N35). The questionnaire includes multi-item scales assessing pain, swallowing, senses, speech, social eating, social contact, and sexuality, as well as single items assessing additional head and neck cancer-related symptoms and problems. Scale and single-item scores will be linearly transformed to a 0-to-100 scale according to the EORTC scoring manual. Higher scores indicate greater symptom burden or more severe problems.

Radiotherapy-related adverse events will be identified and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), version 5.0. For each participant, adverse events will be summarized by event type and maximum CTCAE grade. Results will be reported as the number and proportion of participants experiencing each adverse event and each severity grade. CTCAE grades are defined as Grade 1, mild; Grade 2, moderate; Grade 3, severe; Grade 4, life-threatening or disabling; and Grade 5, death related to an adverse event.