OBJECTIVES: To translate the QOL-RTI H&N for use with German patients. The Quality of Life-Radiation Therapy Instrument Head & Neck (QOL-RTI) is a multidimensional psychometric instrument designed specifically to assess health related quality of life (QoL) in patients undergoing radiation therapy. The head and neck module (H&N) is a companion module to the QOL-RTI for head and neck patients. This instrument differs from other existing tools such as the EORTC H&N or the FACT H&N by including more specific aspects of saliva, taste, swallowing, and local pain in a concise format. METHODS: Healthcare professionals from Austria and Germany translated and linguistically validated the instrument. The current literature reports that translation of existing health status measures is best accomplished with the double-back translation method. This method was used to assure the accurate translation of the tool. It was determined that there is no exact match for some words or phrases, so appropriate translations were derived. RESULTS: Specific difficulties encountered in the translation were determining cultural nuances or slang in the source document. For example, question number 7 in English says I worry about my bills and in the German translation it now says I worry about my financial situation. It was determined that these and several other questions may have different literal meanings in English and German, so words were changed to ensure the same intent (implied meanings) as the original questionnaire. CONCLUSIONS: It is necessary to take great care when translating existing health care measures from one language into another so that the translated version will have content and semantic equivalence across the cultures represented in the project. Psychometric testing is currently being conducted. In addition to German, the QOL-RTI H&N has been translated into Japanese, Italian, Greek and Spanish and is in various stages of validation and testing in these languages.