Spotten L, Corish C, Lorton C, Dhuibhir P Ui, O'Donoghue N, O'Connor B, Cunningham M, El Beltagi N, Gillham C, Walsh D
School of Biological Sciences, Dublin Institute of Technology, Kevin St., Dublin 8, Ireland.
Faculty of Health Sciences, Trinity College Dublin, College Green, Dublin 2, Ireland.
Support Care Cancer. 2016 Jul;24(7):3201-8. doi: 10.1007/s00520-016-3133-2. Epub 2016 Mar 5.
Taste and smell changes (TSCs) are common in head and neck (H&N) cancer and during and after chemotherapy (CT) and radiotherapy (RT). It is an area that has been under-investigated, particularly in the treatment-naive, but can negatively impact nutritional status. This study examined the prevalence, severity and characteristics of TSCs in people with non-H&N solid tumours, before CT and RT, and their relationship with co-occurring symptoms.
A prospective, observational study was conducted. Forty consecutive pre-treatment cancer patients, referred to radiation oncology outpatients over 6 weeks, were recruited. Data on TSCs, symptoms and nutritional status were obtained using the 'Taste and Smell Survey' and the 'abridged Patient-Generated Subjective Global Assessment' (abPG-SGA). BMI was measured. SPSS® was used for statistical analysis. Two-sided P values <0.05 were considered statistically significant.
Most patients were newly diagnosed (n = 28; 70 %). Nineteen (48 %) reported TSCs; nine noted a stronger sweet and seven a stronger salt taste. Of these, four reported a stronger and four a weaker smell sensation. Those at nutritional risk reported more TSCs (n = 13/20). TSCs were significantly associated with dry mouth (P < 0.01), early satiety (P < 0.05) and fatigue (P < 0.05).
TSCs preceded CT or RT in almost half of treatment-naive patients with solid tumours, notably stronger sweet and salt tastes. Half of the study group were at nutritional risk; the majority of these reported TSCs. TSCs were significantly associated with other symptoms. Future research and clinical guidelines, with a common terminology for assessment, diagnosis and management of cancer TSCs, are needed.
味觉和嗅觉改变（TSCs）在头颈部（H&N）癌症患者以及化疗（CT）和放疗（RT）期间及之后很常见。这是一个研究不足的领域，尤其是在未经治疗的患者中，但它会对营养状况产生负面影响。本研究调查了非H&N实体瘤患者在CT和RT之前TSCs的患病率、严重程度和特征，以及它们与同时出现的症状之间的关系。
进行了一项前瞻性观察研究。连续招募了40名在6周内转诊至放射肿瘤门诊的治疗前癌症患者。使用“味觉和嗅觉调查问卷”以及“简化的患者主观整体评估”（abPG-SGA）获取有关TSCs、症状和营养状况的数据。测量了体重指数（BMI）。使用SPSS®进行统计分析。双侧P值<0.05被认为具有统计学意义。
大多数患者为新诊断（n = 28；70%）。19名（48%）报告有味觉和嗅觉改变；9名注意到甜味增强，7名注意到咸味增强。其中，4名报告嗅觉增强，4名报告嗅觉减弱。有营养风险的患者报告的味觉和嗅觉改变更多（n = 13/20）。味觉和嗅觉改变与口干（P < 0.01）、早饱（P < 0.05）和疲劳（P < 0.05）显著相关。
在几乎一半未经治疗的实体瘤患者中，味觉和嗅觉改变先于CT或RT出现，尤其是甜味和咸味增强。研究组中有一半处于营养风险中；其中大多数报告有味觉和嗅觉改变。味觉和嗅觉改变与其他症状显著相关。未来需要开展研究并制定临床指南，采用通用术语对头颈部癌症患者味觉和嗅觉改变进行评估、诊断和管理。
