Natural history of radiotherapy-induced dysgeusia among oral and oropharyngeal cancer patients undergoing different treatment modalities

Abstract

Aims: To assess the patterns of radiotherapy-induced dysgeusia among oral and oropharyngeal squamous cell carcinoma (OOSCC) patients subjected to different oncological treatment modalities. Patients and methods: OOSCC patients who underwent head and neck radiotherapy (HNRT) or chemoradiotherapy (CRT). Patients were paired in 8 groups divided by primary treatment (surgery or induction CT) followed by CRT or HNRT and definitive treatment with CRT or HNRT. Dysgeusia, xerostomia, oral mucositis (OM) grades and tube feeding information were retrieved from electronic medical charts. Statistical analysis was performed regarding the correlation of treatment modalities with dysgeusia, and of xerostomia and OM with dysgeusia. Results: 150 patients were included. Over 90 % of patients developed dysgeusia during HNRT. Groups that included CRT presented early severe dysgeusia. Tongue surgery followed by CRT presented grade 2 at 10Gy when compared to HNRT (p = 0.04), groups with other surgery (such as mandibulectomy) or induction CT followed by CRT presented more grade 2 dysgeusia at 40Gy of HNRT (p = 0.04). Xerostomia and dysgeusia grades and OM and dysgeusia grades presented a positive correlation (P < 0.001, each). Malnutrition associated with appetite loss and dysgeusia was the indication for tube feeding in 26.8 % of patients. Conclusions: CRT protocols may be predictors early-onset dysgeusia. A positive correlation of xerostomia and OM with dysgeusia grades may lead to a decrease in appetite and weight loss. High incidence of tube feeding use due to mal-nutrition associated to appetite loss and dysgeusia highlights the importance of working on strategies for dysgeusia management.

Keywords

• Head and neck cancer
• Head and neck radiotherapy
• Chemotherapy
• Head and neck surgery
• Dysgeusia
• Xerostomia