Department of Internal Medicine, Section On Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Support Care Cancer. 2022 Mar;30(3):2017-2025. doi: 10.1007/s00520-021-06609-8. Epub 2021 Oct 13.
Taste and smell abnormalities (TSA) are common in patients receiving chemotherapy and may lead to altered nutritional intake, treatment withdrawal, and impaired quality of life. Lipid peroxidation in the oral cavity is one cause of TSA. Lactoferrin (LFN), an iron-binding salivary protein, reduces production of lipid oxidation byproducts and has been shown to reduce perception of unpleasant flavors. To assess the feasibility of LFN as a treatment for TSA, we conducted pilot investigations among patients with cancer who self-reported TSA following onset of chemotherapy. The primary objective was to assess change in subjective taste and smell perception from baseline to completion of 30 days of LFN supplementation.
Patients were treated with 750 mg LFN daily for 30 days and followed for an additional 30 days without LFN. TSA was measured via the taste and smell questionnaire (TSQ) including taste (score 0-10), smell (score 0-6), and composite scores (0-16) (0 = no TSA) at baseline, day 30, and day 60.
A total of 26 patients enrolled; 19 remained on study at day 30 and 17 at day 60. Baseline mean TSQ scores were 6.5 (taste), 3.1 (smell), and 9.6 (composite). By day 30, mean composite TSQ score improved by 1.7 (p = 0.018); taste and smell improved by 0.6 (p = 0.062) and 1.1 (p = 0.042), respectively. From baseline to day 60, mean composite TSQ score improved by 3.8 (p < 0.0001); taste and smell improved by 1.9 (p = 0.001) and 1.8 (p = 0.003).
Further evaluation of LFN is warranted to determine its value for improving self-reported TSA among patients receiving chemotherapy.
味觉和嗅觉异常(TSA)在接受化疗的患者中很常见,可能导致营养摄入改变、治疗中断和生活质量受损。口腔内的脂质过氧化是 TSA 的一个原因。乳铁蛋白(LFN)是一种含铁的唾液蛋白,可减少脂质氧化产物的产生,并且已被证明可以降低对不愉快味道的感知。为了评估 LFN 作为治疗 TSA 的可能性,我们在自我报告化疗后出现 TSA 的癌症患者中进行了初步研究。主要目的是评估从基线到 30 天 LFN 补充结束时主观味觉和嗅觉感知的变化。
患者每天接受 750mg LFN 治疗 30 天,并在没有 LFN 的情况下再随访 30 天。通过味觉和嗅觉问卷(TSQ)测量 TSA,包括味觉(得分 0-10)、嗅觉(得分 0-6)和复合得分(0-16)(0=无 TSA),在基线、第 30 天和第 60 天进行测量。
共有 26 名患者入组;19 名患者在第 30 天继续研究,17 名患者在第 60 天继续研究。基线平均 TSQ 评分为 6.5(味觉)、3.1(嗅觉)和 9.6(复合)。到第 30 天,平均复合 TSQ 评分提高了 1.7(p=0.018);味觉和嗅觉分别提高了 0.6(p=0.062)和 1.1(p=0.042)。从基线到第 60 天,平均复合 TSQ 评分提高了 3.8(p<0.0001);味觉和嗅觉分别提高了 1.9(p=0.001)和 1.8(p=0.003)。
需要进一步评估 LFN 以确定其在改善接受化疗的患者自我报告的 TSA 方面的价值。