Prospective assessment of gustatory function after radiotherapy for head and neck cancers
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RHINOLOGY
Prospective assessment of gustatory function after radiotherapy for head and neck cancers Eun Jung Lee1 · Chi Sang Hwang1 · Hui Joon Yang1 · Hee Sung Chae1 · Hyun Jong Jeon1 · Dong‑Joon Park1 Received: 9 April 2020 / Accepted: 12 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Taste disorders are major causes of morbidity in patients undergoing head and neck irradiation. We quantitatively assessed the gustatory function of patients with head and neck cancers who underwent radiotherapy using recently developed standardised tools for measuring taste. Methods Twenty patients undergoing head and neck irradiation responded to a specific questionnaire and were assessed by olfactory and gustatory function tests. To assess changes over time, testing was performed before, immediately after, and at 2- and 4-week intervals following the start of radiotherapy. Concurrently, patients were evaluated for xerostomia from radiotherapy. Results A decrease in the taste recognition threshold was observed in the second week after the beginning of radiotherapy. The taste detection threshold improved within the 14th–18th week. Most affected patients demonstrated that their gustatory function primarily decreased independent of the olfactory function. Disturbances in taste were exponentially worsened beyond an accumulated dose of 30 Gy and involved all tastants. According to a multivariate analysis, radiation-induced taste impairment was not influenced by the degree of xerostomia. However, there was an association between the dose of irradiation and the severity of taste disturbance. Conclusions In this preliminary study, we found that the taste function was worse 2 weeks after the start of radiotherapy and returned to pretreatment levels within 4.5 months. Taste disturbances were exponentially worse beyond an accumulated dose of 20 Gy. Taste dysfunction after radiotherapy was not influenced by the degree of xerostomia, whereas only the dose of irradiation was associated with the severity of taste dysfunction. Keywords Head and neck cancer · Prospective · Radiotherapy · Taste · Xerostomia · Olfaction
Introduction Radiotherapy with or without chemotherapy and/or surgery is an established form of therapy for the curative treatment or palliation of head and neck cancer. Although better radiotherapy target definitions with adjacent healthy tissue Eun Jung Lee and Dong-Joon Park contributed equally as corresponding author. * Eun Jung Lee [email protected]; [email protected] * Dong‑Joon Park [email protected] 1
Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Ilsan‑ro 20, Wonju, South Korea
avoidance have aimed at better locoregional disease control and higher survival rates in recent years, different types of radiotherapy-related functional sequels, such as dysphagia, xerostomia, and trismus still occur [1–4]. One of the most frequent complaints of patients undergoing radiotherapy for head and neck cancer is taste dysfunction. Complaints of taste
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