Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Department of Otorhinolaryngology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.
Support Care Cancer. 2021 Mar;29(3):1635-1641. doi: 10.1007/s00520-020-05639-y. Epub 2020 Aug 4.
Olfactory sensory neurons and the olfactory mucosa are both important for optimal olfactory function. The potential nasal mucosal toxicity of chemotherapy regimens has not been assessed yet. The aim of this study was to objectively investigate the effect of chemotherapy on mucociliary clearance and olfactory function and to evaluate whether this effect differs between different chemotherapy regimens and age groups.
The study included consecutive patients admitted for the treatment of a variety of primary tumors (except head and neck and brain malignancies). Patients were evaluated for olfaction and mucociliary clearance before and immediately after completing the last session of chemotherapy cycles, according to the therapeutic protocol. For objective evaluation, the saccharine test was used for mucociliary clearance and the Sniffin' Sticks test for olfactory function. Of the 46 initial patients, 30 completed the study. Groups were formed according to the chemotherapy regimen (four groups: CA (doxorubicin + cyclophosphamide), Folfox (oxaliplatin +5-FU + folinic acid), DCF (docetaxel + cisplatin +5-FU), and GC (gemcitabine + cisplatin)) and according to age (two groups: < 55 years and > 55 years).
In the overall analyses, significant deterioration was noted in both mucociliary clearance time and smell scores (olfactory threshold (OT), olfactory discrimination (OD), olfactory identification (OI), and the composite threshold-discrimination-identification (TDI) score). The changes in these scores showed no significant differences between chemotherapy groups. The decrease in OT and global TDI scores was more severe in the younger age group.
Chemotherapy impairs both the mucociliary clearance and olfactory function in cancer patients. This might reflect the collective negative effect of chemotherapy on olfactory function, not only through the neurocytotoxic effect but also the cytotoxic effect on the nasal mucosa. In addition, the reduction in olfactory threshold and total olfactory function scores was seen to be more profound in younger patients, which could have been due to higher initial scores.
嗅觉神经元和嗅黏膜对于最佳嗅觉功能都很重要。尚未评估化疗方案对鼻黏膜的潜在毒性。本研究旨在客观评估化疗对黏液纤毛清除率和嗅觉功能的影响，并评估这种影响是否因不同的化疗方案和年龄组而不同。
该研究纳入了连续因各种原发性肿瘤（头颈部和脑恶性肿瘤除外）接受治疗的患者。根据治疗方案，在完成最后一次化疗周期后，立即对患者进行嗅觉和黏液纤毛清除率评估。为了进行客观评估，使用糖精测试评估黏液纤毛清除率，使用嗅探棒测试评估嗅觉功能。在最初的 46 名患者中，有 30 名完成了研究。根据化疗方案（4 组：CA（多柔比星+环磷酰胺）、Folfox（奥沙利铂+5-FU+亚叶酸）、DCF（多西他赛+顺铂+5-FU）和 GC（吉西他滨+顺铂））和年龄（<55 岁和>55 岁）将患者分为两组。
在总体分析中，黏液纤毛清除时间和气味评分（嗅觉阈值（OT）、嗅觉辨别（OD）、嗅觉识别（OI）和复合阈值-辨别-识别（TDI）评分）均显著恶化。这些评分的变化在化疗组之间无显著差异。在年龄较小的组中，OT 和总体 TDI 评分的下降更为严重。
化疗会损害癌症患者的黏液纤毛清除率和嗅觉功能。这可能反映了化疗对嗅觉功能的集体负面影响，不仅通过神经细胞毒性作用，还通过对鼻黏膜的细胞毒性作用。此外，在年轻患者中，嗅觉阈值和总嗅觉功能评分的降低更为明显，这可能是由于初始评分较高所致。
