Late Sensorial Alterations in Different Radiotherapy Techniques for Nasopharyngeal Cancer

Riva, Giuseppe; Raimondo, Luca; Ravera, Mattia; Moretto, Francesco; Boita, Monica; Potenza, Ilenia; Rampino, Monica; Ricardi, Umberto; Garzaro, Massimiliano

doi:10.1093/chemse/bjv011

Cited by 22 publications

(26 citation statements)

References 43 publications

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“…Riva et al have published the only study (to our knowledge) with objective taste measurements >1 year after RT [29]. Similar to this study it was found that even after a follow-up of 2-10 years (median 4.9), the majority of the 30 nasopharyngeal cancer (NPC) patients still suffered from taste changes (53% vs. 7% in ''healthy" control group).…”

Section: Subsequent Dynamic In Taste Impairment (1-5 Mdasi Assessmentsupporting

confidence: 77%

Prospective observational evaluation of radiation-induced late taste impairment kinetics in oropharyngeal cancer patients: Potential for improvement over time?

Stieb

Mohamed

Deshpande

et al. 2020

Clinical and Translational Radiation Oncology

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Background and purpose: Taste impairment is a common radiation-induced toxicity in head and neck cancer (HNC) patients acutely. However, data on the potential for recovery and the time dependent course of late taste impairment are limited. Materials and methods: As part of an IRB-approved observational prospective study, HNC patients underwent serial surveys including the MD Anderson Symptom Inventory-Head and Neck module (MDASI-HN). For our analysis, we extracted MDASI-HN taste item results from oropharyngeal cancer patients treated with intensity-modulated radiotherapy or volumetric modulated arc therapy and at least two taste assessments after !1 year from end of radiotherapy (RT). Results: 1214 MDASI taste items from 326 patients between 1 and 13 years post-RT were included. Median prescribed dose to the high-dose clinical target volume (CTV1) was 66.0 Gy, with 180 patients (55%) receiving chemotherapy. Taste markedly improved in the first years from end of RT, but plateaued after year 5. In patients with taste assessment in subsequent years, a significant reduction in taste impairment was found from the second to the third year (p = 0.001) and tended towards significance from the third to the fourth year (p = 0.058). Multivariate analysis revealed treatment site as significant factor in the sixth year from RT and CTV1 dose and age in the seventh year. Conclusion: Radiation-induced taste impairment may improve over an extended time interval, but becomes relatively stable from year 5 post-RT. Direct characterization of RT-induced taste impairment and the calculation of normal tissue complication probability should include consideration of the timedependent course in taste recovery.

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Section: Subsequent Dynamic In Taste Impairment (1-5 Mdasi Assessmentsupporting

confidence: 77%

Prospective observational evaluation of radiation-induced late taste impairment kinetics in oropharyngeal cancer patients: Potential for improvement over time?

Stieb

Mohamed

Deshpande

et al. 2020

Clinical and Translational Radiation Oncology

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“…In contrast, when evaluating these patients at 12 months post-treatment, they demonstrated normal values for the identification of odorous substances 20,21 . The study led by Riva et al pointed out that, 5 years after radiotherapy, there are no major changes in the qualitative identification of odour 22 . The explanation that can be given in this regard is precisely the re-education of nasal breathing in patients with tracheal cannula.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of smell disorders after radiotherapy in patients with laryngeal neoplasm

Műhlfay

Neagos

et al. 2020

Romanian Journal of Rhinology

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BACKGROUND. Smell disorders may be classified in quantitative and qualitative. The literature shows that the main causes of odour disorders, both qualitative and quantitative, are due to aging, viral infections and tumors of the upper respiratory tract, craniocerebral trauma, neurodegenerative diseases of the nervous system, drug use or exposure to various toxic substances. Total laryngectomy and oncologic treatment causes smell disorders.OBJECTIVE. The aim of this study is to evaluate the aspects related to the patient’s smell disorders after total laryngectomy, during the oncological treatment represented by radiotherapy.MATERIAL AND METHODS. A prospective observational study was performed on a group of 52 patients, over a period of one year (2016-2017), who benefited from total laryngectomy and who underwent oncological treatment, represented by radiotherapy. Patients were evaluated before starting radiotherapy and during radiotherapy sessions. All patients underwent quantitative and qualitative smell assessment.RESULTS. At the end of week 7 of radiotherapy, none of the patients was considered normosmic, 10 patients were considered to be suffering from hyposmia and 42 from anosmia. Statistically significant changes in the quantitative determination of odour occurred in the fourth week, respectively at the radiation dose of 40Gy. Qualitative odour assessment in this study showed a statistically significant decrease starting with the fifth week of radiotherapy, respectively with a radiation dose of 50Gy.CONCLUSION. Radiation therapy has a major impact on the quality of life of patients with laryngeal cancer, which has the lowest scores at the beginning and end of the treatment.

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“…Irradiated patients for nasopharyngeal cancer show a prominent alteration in olfactory threshold score, compared to odor discrimination and identification. 10,11 This suggests that suprathreshold functioning is not altered since it involves higher brain centers, which are spared from RT delivered to the nasopharynx. 10,11 Moreover, adaptation to sensorial impairment could explain the discrepancy between reported subjective symptoms (hyposmia 30%) and objective measurements (hyposmia 86%).…”

Section: Discussionmentioning

confidence: 99%

“…10,11 This suggests that suprathreshold functioning is not altered since it involves higher brain centers, which are spared from RT delivered to the nasopharynx. 10,11 Moreover, adaptation to sensorial impairment could explain the discrepancy between reported subjective symptoms (hyposmia 30%) and objective measurements (hyposmia 86%). 11 The absence of correlation between clinical findings (inferior turbinate hypertrophy, nasal mucositis) and late olfactory impairment suggests that threshold score alterations may be related to a sensorineural deficit of olfactory mucosa or nerve fibers, rather than conductive problems.…”

Section: Discussionmentioning

confidence: 99%

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Radiation-Induced Rhinitis: Cytological and Olfactory Changes

Riva

Franco

Provenzano

et al. 2019

Am J Rhinol�Allergy

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Background Oral mucositis is a well-known adverse event of radiotherapy (RT) for head and neck cancer (HNC). Its nasal counterpart, the radiation-induced rhinitis, is poorly studied and considered in clinical practice. Objective The aim of this observational study was to evaluate acute cytological and olfactory alterations during RT and their correlation with RT doses. Methods Ten patients who underwent RT for HNC, excluding tumors of the nasal cavities, were evaluated with nasal scraping for cytological examination, Sniffin’ Sticks test for olfactory assessment, and Nasal Obstruction Symptom Evaluation scale. The examinations were performed before (T0), at mid-course (T1), and at the end (T2) of RT. They were repeated 1 and 3 months after RT (T3 and T4). Mean dose (Dmean) and near maximum dose (D2%) to nasal cavities and inferior turbinates were used for correlation analyses. Results Radiation-induced rhinitis was present in 70% of patients at T2, and it was still observed in 40% of cases after 3 months. Although olfactory function remained within the normal range at the evaluated times, a significant decrease in odor threshold and discrimination was observed during RT, which returned to baseline levels after RT. Nasal cytology showed a radiation-induced rhinitis with neutrophils and sometimes bacteria. Mucous and squamous cell metaplasia appeared in 10% of patients. Dmean and D2% to inferior turbinates were associated to neutrophilic rhinitis at T2, and D2% to inferior turbinates was correlated to mucous cell metaplasia at T2. Conclusions RT for HNC induces acute rhinitis that may persist after the completion of treatment and can affect patient’s quality of life. Nasal cytology can help to choose the best treatment on an individual basis.

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Late Sensorial Alterations in Different Radiotherapy Techniques for Nasopharyngeal Cancer

Cited by 22 publications

References 43 publications

Prospective observational evaluation of radiation-induced late taste impairment kinetics in oropharyngeal cancer patients: Potential for improvement over time?

Prospective observational evaluation of radiation-induced late taste impairment kinetics in oropharyngeal cancer patients: Potential for improvement over time?

Evaluation of smell disorders after radiotherapy in patients with laryngeal neoplasm

Radiation-Induced Rhinitis: Cytological and Olfactory Changes

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