The effect of radiotherapy on taste sensation in head and neck cancer patients – a prospective study

Abstract

Background: One of the main side effects of head and neck (H&N) radiation therapy (RT) is alteration in taste sensation. It causes significant morbidity and has a major effect on quality of life (QoL). The aim of this study was to prospectively define the effect of RT on taste sensation (general, and four basic tastes) and correlate these findings with changes in saliva secretion and QoL questionnaires. Methods: Patients with H&N cancer treated with RT, in which the oral cavity was expected to receive a mean dose of 30 Gray (Gy). Patients were evaluated by Whole-Saliva Sialometry, validated Taste Strips and European Organization for Research and Treatment of Cancer H&N QoL questionnaires prior to RT (T0), mid-point of radiotherapy dose (T1), at the end of radiotherapy (T2) and 1 (T3), 3 (T4) and 12 months (T5) after completion of treatment course. Results: Twenty-eight patients were recruited, and 21 patients completed study procedures and were analyzed. Median age was 66 years (range 18-90). The most common tumor site was the oral cavity. The median prescribed radiation dose to the high dose volume was 66 (range 60-70). The median mean and max dose to the oral cavity were 25.1 (range 14-69) and 64.9 (range 30-70), respectively. There was a significant decrease in overall taste sensation between T0 and T1 and T2. With specific tastes, there were significant decreases in sensation of sweet and salty, a trend with bitter and no change with sour. All returned to baseline at T3 and onwards. There was no significant correlation between the max or mean dose to the oral cavity and overall taste sensation or between doses to different areas of the tongue and overall or specific tastes. At T0 there was a significant positive correlation between overall taste sensation and whole-saliva sialometry, and at T1 and T2 there were strong trends. There were significant declines in QoL scores during RT. Conclusions: We found a significant immediate reduction in taste sensation due to RT in H&N cancer patients with taste recovery 1 month after treatment completion. There were strong trends to a correlation with saliva production that requires further exploration.

Treatment-Related Dysgeusia in Oral and Oropharyngeal Cancer: A Comprehensive Review

“…Abnormal sensitization of the chorda tympani nerve can result in specific taste sensations without stimulating the taste receptors or requiring the presence of the corresponding flavor molecules [18]. Altered taste has been found to occur consistently within 3-5 days of starting CMT, and it usually returns within 3 weeks, although there have been reports of persistence of symptoms for more than 6 months [6,15]. Dysgeusia represents an early symptom that drastically worsens the QOL of patients undergoing CMT, by direct and indirect effects on cell proliferation and neuronal activity.…”

“…Each taste bud contains 40-120 cells, classified into taste receptor cells, support cells, and precursor cells. Taste buds are mainly located on the tongue dorsum, but can also be found on the buccal mucosa, floor of the mouth, oropharynx, epiglottis, pharynx, larynx, and in the upper third of esophagus [6,7,13,15,16]. Some taste cells were estimated to have a half-life of 8-12 days, while others reached a 24-day half-life [15,16].…”

“…Taste buds are mainly located on the tongue dorsum, but can also be found on the buccal mucosa, floor of the mouth, oropharynx, epiglottis, pharynx, larynx, and in the upper third of esophagus [6,7,13,15,16]. Some taste cells were estimated to have a half-life of 8-12 days, while others reached a 24-day half-life [15,16]. Taste signals are transmitted by several nerves: the chorda tympani (branch of facial nerve), the glossopharyngeal, the upper laryngeal (branch of vagus nerve), and the lingual (branch of trigeminus nerve).…”

Toxicities Caused by Head and Neck Cancer Treatments and Their Influence on the Development of Malnutrition: Review of the Literature

“…The administration of treatment can affect the taste receptors, with taste reportedly one of the main characteristics to be susceptible to alteration [ 53 ]. For patients with HNC receiving RT, there is no correlation observed between the dose of administered RT and taste sensation, with these changes also experienced prior to treatment due to loss of taste buds caused by surgery, or the tumor location [ 54 ]. Several changes in taste perception are reported, including the absence or incorrect perception of flavor; most commonly the perception of metallic, salty, and bitter tastes.…”

Palliative oral care in patients undergoing radiotherapy: Integrated review

“…[ 12 ] The loss of taste sensation can alter the food habit that can alter the nutritional status of an individual. [ 15 ]…”