The influence of radiation dose on taste impairment in a prospective observational study cohort of oropharyngeal cancer patients

Stieb, Sonja; Engeseth, Grete May; Mohamed, A.S.R.; He, Renjie; Perez-Martinez, I.; Rock, S.; Deshpande, T.S.; Garden, Adam S.; Rosenthal, D.I.; Frank, Steven J.; Gunn, G.B.; Fuller, Clifton D.

doi:10.1080/0284186x.2021.2022204

Cited by 4 publications

(1 citation statement)

References 18 publications

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“…However, our analysis delved deeper into the significance of symptoms by conducting Spearman’s correlation coefficient analysis for the time points immediately after the completion of treatment and the one 3 months after it ( Table 1 and Table 2 respectively). We found moderate statistical significance between certain symptoms (such as pain, swallowing difficulty, and dry mouth) and dosimetric data at the Organs at Risk (OARs) similarly to other research teams [ 24 , 25 ]. Conversely, symptoms like appetite loss, sticky mouth, and sensory problems showed low statistical correlation with dosimetric data.…”

Section: Discussionsupporting

confidence: 78%

Unravelling Quality of Life for Head and Neck Cancer Patients after VMAT Radiation Therapy: Insights from Toxicity, Dosimetry and Symptoms Correlation

Kiafi,

Kouri,

Patatoukas

et al. 2024

Clinics and Practice

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(1) Background: Head and neck cancer treatment, including advanced techniques like Volumetric Modulated Arc Therapy (VMAT), presents challenges for maintaining patient quality of life (QoL). Thus, thoroughly investigating how radiation therapy (RT) affects patients has been proved essential. Derived by that, this study aims to understand the complex interactions between not only RT and QoL but also symptom severity, and treatment-related toxicities in three distinct time points of patient’s treatment; (2) Methods: To achieve that, EORTC-QLQ-C30 and EORTC QLQ-H&N35 questionnaires were used in combination with EORTC_RTOG scoring criteria and Spearman’s rho statistical analysis for 74 patients with cancer undergoing VMAT radiation therapy; (3) Results: The results revealed a significant improvement in the Overall Health Index post-treatment, indicating a temporary decline during therapy followed by subsequent recovery, often surpassing pre-treatment QoL levels. Concurrently a reduction in symptomatology was observed, notably in pain, swallowing difficulties, and dry mouth, aligning with prior research indicating decreased symptom burden post-treatment. However, Spearman’s correlation coefficient analysis at two distinct time points during therapy uncovered varying degrees of correlation between dosimetric data at Organs at Risk (OARs) and reported symptoms, highlighting potential limitations in using QoL questionnaires as sole indicators of treatment efficacy. Our investigation into the correlation between dosimetric data, toxicity, and symptoms focused on the relationship between radiation doses and oral mucositis levels, a common toxicity in head and neck cancer patients. Significant associations were identified between toxicity levels and dosimetric parameters, particularly with OARs such as the parotid glands, oral cavity, and swallowing muscles, underlining the utility of the EORTC method as a reliable toxicity assessment tool; (4) Conclusions: To summarize, current research attempts to underscore the importance of refining QoL assessments for enhanced patient care. The integration of dosimetric data, symptom severity, and treatment-related toxicities in the QoL outcomes of head and neck cancer patients undergoing VMAT radiation therapy, can lead towards the optimization of treatment strategies and the improvement of patient outcomes in future patient-centered radiation therapy practices.

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Section: Discussionsupporting

confidence: 78%

Unravelling Quality of Life for Head and Neck Cancer Patients after VMAT Radiation Therapy: Insights from Toxicity, Dosimetry and Symptoms Correlation

Kiafi,

Kouri,

Patatoukas

et al. 2024

Clinics and Practice

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Impact of radiation dose on patient-reported acute taste alteration in a prospective observational study cohort in head and neck squamous cell cancer (HNSCC)

Morelli,

Desideri,

Romei

et al. 2023

Radiol med

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Purpose Taste alteration (TA) is a frequent acute side effect of radiation treatment in HNSCC patients. Principal aim of our study was to investigate dosimetric parameters in relation to patient-assessed taste impairment in a prospective cohort treated with intensity-modulated radiotherapy. Methods All patients with locally advanced HNSCC and amenable to radical treatment were included. Chemotherapy-induced taste alteration scale (CITAS), EORTC QLQ-C30 and QLQ-HN43 questionnaires at baseline (T0), 3 weeks (T1) and 3 months (T2) after radiotherapy conclusion were used to assess taste impairment. Base of tongue, submandibular glands (SG), parotid glands (PG) and taste buds, along with anterior and medium third of the tongue, were considered as organs at risk and thus delineated according to consensus guidelines. The mean dose to the above-mentioned structures was correlated with patient-reported outcomes. Results Between September 2019 and November 2020, 33 patients were recruited, 31 of which analyzed. 71% had oropharyngeal carcinoma, mostly HPV-related (60%). All were treated with tomotherapy. 77.4% had concurrent cisplatin. Mean scores of general taste alterations, global health status and dry mouth and sticky saliva were assessed. The mean doses to the anterior third, medium third and base of the tongue were 23.85, 35.50 and 47.67 Gy, respectively. Taste buds received 32.72 Gy; right and left parotid 25 and 23 Gy; right and left submandibular glands 47.8 and 39.4 Gy. At univariate analysis, dysgeusia correlated with SG mean dose (95% CI 0–0.02 p = 0.05) and PG mean dose (95% CI 0–0.02 p = 0.05); dry mouth with mean dose to anterior (95% CI 0.03–1.47 p = 0.04) and medium third (95% CI 0.02–0.93 p = 0.04) of the tongue, to taste buds (95% CI 0.06–0.96 p = 0.03) and to SGs (95% CI 0.06–0.63 p = 0.02); pain mouth with mean dose to taste buds (95% CI 0–0.02 p = 0.04), to SGs (95% CI 0–0.03 p = 0.03) and to base tongue (95% CI 0–0.02 p = 0.02). Conclusions Our analysis supports the influence of dose distribution on the development of TA in HNSCC patients. The contribution of dose to taste buds and tongue subvolumes remains unclear and worthy of further investigation.

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Radiation-associated changes in saliva composition of head and neck cancer patients: A systematic review

Staruch,

Speth,

Neyer

et al. 2024

Radiotherapy and Oncology

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The influence of radiation dose on taste impairment in a prospective observational study cohort of oropharyngeal cancer patients

Cited by 4 publications

References 18 publications

Unravelling Quality of Life for Head and Neck Cancer Patients after VMAT Radiation Therapy: Insights from Toxicity, Dosimetry and Symptoms Correlation

Unravelling Quality of Life for Head and Neck Cancer Patients after VMAT Radiation Therapy: Insights from Toxicity, Dosimetry and Symptoms Correlation

Impact of radiation dose on patient-reported acute taste alteration in a prospective observational study cohort in head and neck squamous cell cancer (HNSCC)

Radiation-associated changes in saliva composition of head and neck cancer patients: A systematic review

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