Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Institute of Oncology, Davidoff Center, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.
Radiat Oncol. 2020 Jun 5;15(1):144. doi: 10.1186/s13014-020-01578-4.
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.
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.
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.
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.
头颈部（H&N）放射治疗（RT）的主要副作用之一是味觉改变。它会导致显著的发病率，并对生活质量（QoL）产生重大影响。本研究的目的是前瞻性地定义 RT 对味觉（总体味觉和四种基本味觉）的影响，并将这些发现与唾液分泌和 QoL 问卷的变化相关联。
接受 H&N 癌症治疗的患者，预计口腔将接受 30 格雷（Gy）的平均剂量。在 RT 之前（T0）、放射剂量中点（T1）、放射治疗结束时（T2）以及 1（T3）、3（T4）和 12 个月（T5）后，使用全唾液唾液腺测量法、经验证的味觉条和欧洲癌症研究和治疗组织 H&N QoL 问卷对患者进行评估。
共招募了 28 名患者，其中 21 名患者完成了研究程序并进行了分析。中位年龄为 66 岁（范围 18-90 岁）。最常见的肿瘤部位是口腔。高剂量体积的中位处方辐射剂量为 66（范围 60-70）。口腔的中位平均和最大剂量分别为 25.1（范围 14-69）和 64.9（范围 30-70）。在 T0 和 T1 以及 T2 之间，总体味觉感觉明显下降。在特定味觉方面，甜味和咸味感觉明显下降，苦味呈下降趋势，酸味无变化。所有味觉均在 T3 及以后恢复到基线。口腔的最大或平均剂量与总体味觉感觉或舌不同部位的剂量与总体或特定味觉之间无显著相关性。在 T0 时，总体味觉感觉与全唾液唾液腺测量法之间存在显著正相关，在 T1 和 T2 时存在强烈趋势。在 RT 期间，QoL 评分显著下降。
我们发现 H&N 癌症患者在接受 RT 后，味觉会立即显著下降，在治疗结束后 1 个月味觉恢复。与唾液产生之间存在强烈的趋势，需要进一步探讨。
