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Table 1 The Functional Assessment of Cancer Therapy-EGFRI 18 (FACT-EGFRI 18)

From: A prospective study to validate the functional assessment of cancer therapy (FACT) for epidermal growth factor receptor inhibitor (EGFRI)-induced dermatologic toxicities FACT-EGFRI 18 questionnaire: SWOG S1013

Instructions: “Below is a list of statements that other people with your illness have said are important. Please check one box per line to indicate your response as it applies to the past 7 days.”
Item No. Item Response category
Not at all A little bit Somewhat Quite a bit Very much
1 My skin or scalp feels irritated      
2 My skin or scalp is dry or “flaky”      
3 My skin or scalp itches      
4 My skin bleeds easily      
5 I am bothered by a change in my skin’s sensitivity to the sun      
6 My skin condition interferes with my ability to sleep      
7 My skin condition affects my mood      
8 My skin condition interferes with my social life      
9 I am embarrassed by my skin condition      
10 I avoid going out in public because of how my skin looks      
11 I feel unattractive because of how my skin looks      
12 Changes in my skin condition make daily life
Difficult
     
13 The skin side effects from treatment have interfered with household tasks      
14 My eyes are dry      
15 I am bothered by sensitivity around my fingernails or toenails      
16 Sensitivity around my fingernails makes it difficult to perform household tasks      
17 I am bothered by hair loss      
18 I am bothered by increased facial hair      
  1. Note: FACT-EGFRI 18 measure and scoring instructions are available at the following website: https://www.facit.org/FACITOrg/Questionnaires