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Aljishi M, Yom SS, Shiboski CH, Villa A. Assessing the knowledge and awareness of US oncologists regarding the specialty of oral medicine. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:38-45. [PMID: 38704350 DOI: 10.1016/j.oooo.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 03/17/2024] [Accepted: 03/30/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES This cross-sectional study aimed to assess the awareness among United States (US) oncologists about oral medicine (OM) as a specialty of dentistry, and their collaboration with OM providers. METHODS An online survey was conducted, inviting 1350 US oncologists, with data collected on demographics, practice background, comfort level with diagnosing and treating oral conditions, referral practices for oral conditions, and more. RESULTS Of the invited 1350 oncologists, 192 responded (14% response rate). Among respondents, 46% were familiar with the OM specialty. Of these, 73% had previously sought consultation from OM specialists. The primary reasons for referral included dental clearance before initiating chemotherapy (38.5%), dental clearance before initiating radiotherapy (37%), and managing oral ulcers and oral potentially malignant disorders equally (32.2%). Regarding referrals to providers outside of OM, oncologists primarily referred patients with oral lesions to otolaryngologists (64.6%), followed by oral and maxillofacial surgeons (55.2%) and general dentists (45.3%). CONCLUSION Our study showed that over half of US oncologists were unfamiliar with the OM specialty. However, the referral rate to OM providers was high among oncologists who had prior OM knowledge. It is advisable to enhance the collaboration between OM and oncology specialists to ensure optimal care for patients with cancer.
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Affiliation(s)
- Morooj Aljishi
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA; Department of Biomedical Science, College of Dentistry, Imam Abdulrahman bin Faisal University, IAU, Saudi Arabia.
| | - Sue S Yom
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Caroline H Shiboski
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA; Oral Medicine, Oral Oncology and Dentistry, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
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Foote RL, Harmsen WS, Amundson AC, Carr AB, Gamez ME, Garces YI, Lester SC, Ma DJ, McGee LA, Moore EJ, Neben Wittich MA, Patel SH, Routman DM, Rwigema JCM, Van Abel KM, Yin LX, Muller OM, Shiraishi S. Mean Oral Cavity Organ-at-Risk Dose Predicts Opioid Use and Hospitalization during Radiotherapy for Patients with Head and Neck Tumors. Cancers (Basel) 2024; 16:349. [PMID: 38254837 PMCID: PMC10814074 DOI: 10.3390/cancers16020349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Approximately 75% of all head and neck cancer patients are treated with radiotherapy (RT). RT to the oral cavity results in acute and late adverse events which can be severe and detrimental to a patient's quality of life and function. The purpose of this study was to explore associations between RT dose to a defined oral cavity organ-at-risk (OAR) avoidance structure, provider- and patient-reported outcomes (PROs), opioid use, and hospitalization. METHODS This was a retrospective analysis of prospectively obtained outcomes using multivariable modeling. The study included 196 patients treated with RT involving the oral cavity for a head and neck tumor. A defined oral cavity OAR avoidance structure was used in all patients for RT treatment planning. Validated PROs were collected prospectively. Opioid use and hospitalization were abstracted electronically from medical records. RESULTS Multivariable modeling revealed the mean dose to the oral cavity OAR was significantly associated with opioid use (p = 0.0082) and hospitalization (p = 0.0356) during and within 30 days of completing RT. CONCLUSIONS The findings of this study may be valuable in RT treatment planning for patients with tumors of the head and neck region to reduce the need for opioid use and hospitalization during treatment.
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Affiliation(s)
- Robert L. Foote
- Department of Radiation Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (A.C.A.); (M.E.G.); (Y.I.G.); (S.C.L.); (D.J.M.); (M.A.N.W.); (D.M.R.)
| | - W. Scott Harmsen
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA;
| | - Adam C. Amundson
- Department of Radiation Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (A.C.A.); (M.E.G.); (Y.I.G.); (S.C.L.); (D.J.M.); (M.A.N.W.); (D.M.R.)
| | - Alan B. Carr
- Department of Dental Specialties, Division of Esthetic and Prosthetic Dentistry, Department of Advanced Prosthodontics, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (A.B.C.); (O.M.M.)
| | - Mauricio E. Gamez
- Department of Radiation Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (A.C.A.); (M.E.G.); (Y.I.G.); (S.C.L.); (D.J.M.); (M.A.N.W.); (D.M.R.)
| | - Yolanda I. Garces
- Department of Radiation Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (A.C.A.); (M.E.G.); (Y.I.G.); (S.C.L.); (D.J.M.); (M.A.N.W.); (D.M.R.)
| | - Scott C. Lester
- Department of Radiation Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (A.C.A.); (M.E.G.); (Y.I.G.); (S.C.L.); (D.J.M.); (M.A.N.W.); (D.M.R.)
| | - Daniel J. Ma
- Department of Radiation Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (A.C.A.); (M.E.G.); (Y.I.G.); (S.C.L.); (D.J.M.); (M.A.N.W.); (D.M.R.)
| | - Lisa A. McGee
- Department of Radiation Oncology, Mayo Clinic Arizona, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA; (L.A.M.); (S.H.P.); (J.-C.M.R.)
| | - Eric J. Moore
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (E.J.M.); (K.M.V.A.); (L.X.Y.)
| | - Michelle A. Neben Wittich
- Department of Radiation Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (A.C.A.); (M.E.G.); (Y.I.G.); (S.C.L.); (D.J.M.); (M.A.N.W.); (D.M.R.)
| | - Samir H. Patel
- Department of Radiation Oncology, Mayo Clinic Arizona, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA; (L.A.M.); (S.H.P.); (J.-C.M.R.)
| | - David M. Routman
- Department of Radiation Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (A.C.A.); (M.E.G.); (Y.I.G.); (S.C.L.); (D.J.M.); (M.A.N.W.); (D.M.R.)
| | - Jean-Claude M. Rwigema
- Department of Radiation Oncology, Mayo Clinic Arizona, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA; (L.A.M.); (S.H.P.); (J.-C.M.R.)
| | - Kathryn M. Van Abel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (E.J.M.); (K.M.V.A.); (L.X.Y.)
| | - Linda X. Yin
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (E.J.M.); (K.M.V.A.); (L.X.Y.)
| | - Olivia M. Muller
- Department of Dental Specialties, Division of Esthetic and Prosthetic Dentistry, Department of Advanced Prosthodontics, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA; (A.B.C.); (O.M.M.)
| | - Satomi Shiraishi
- Division of Medical Physics, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA;
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Tharakan T, Piccirillo JF, Miller B, Reed DR, Kallogjeri D, Paniello R, Puram SV, Jackson RS. Acute Taste Dysfunction in Oropharyngeal Cancer Patients after Transoral Robotic Surgery. Laryngoscope 2023; 133:3520-3528. [PMID: 37551882 PMCID: PMC10843268 DOI: 10.1002/lary.30939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/23/2023] [Accepted: 07/17/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES To compare taste changes after transoral robotic surgery (TORS) to taste changes in healthy controls. METHODS Oropharyngeal cancer patients receiving TORS and healthy controls were recruited. Participants underwent posterolateral and whole-mouth psychophysical taste testing (identification, intensity, and hedonics) at baseline and at 2 weeks postoperatively (patients) or follow-up (controls). Surgeons reported suspension time and glossopharyngeal nerve injury (GNI) based on the identification and sacrifice of the nerve. A Clinical Global Impression (CGI) of taste symptoms was completed at each session ("My sense of taste bothers me" on a 5-point scale from Never [1] to Always [5]). A taste disorder (TD) was a CGI of 3 (Sometimes) or worse. Within-subject changes in CGI and psychophysical scores were computed. "Worsened taste" was a CGI increase by ≥1 point at follow-up. RESULTS Of 69 participants, most (33/37 tumor, 31/32 controls) had normal baseline taste (CGI < 3). 14/33 (42%) TORS patients and no controls developed new TDs at follow-up. More smokers (7/9) had worsened taste than nonsmokers (19/60, difference = 46% [95% CI 16%-76%]). More patients without GNI (6/22) than with GNI (0/15) had postoperative phantogeusia (difference = 27% [95% CI 9-45%]). Tumor-ipsilateral taste identification (TI) decreased more in patients (-11.3%) than controls (0.8%, difference = 12.2% [95% CI 5.0-19.3%]). Suspension time was not associated with worsened taste symptoms or psychophysical changes. CONCLUSIONS Patient-reported taste changes after TORS are frequent. Compared to healthy controls, TORS patients have decreased tumor-ipsilateral TI. Suspension time and GNI are unlikely to cause symptomatic TDs. Further investigations of the etiology and long-term symptom burden of TORS-associated TDs will aid in the management of oropharyngeal cancer patients. LEVEL OF EVIDENCE 3 (non-randomized controlled cohort study) Laryngoscope, 133:3520-3528, 2023.
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Affiliation(s)
- Theresa Tharakan
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Jay F. Piccirillo
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Brevin Miller
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
- School of Medicine, University of Missouri Kansas City, Kansas City, MO
| | | | - Dorina Kallogjeri
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Randall Paniello
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Sidharth V. Puram
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
- Department of Genetics, Washington University School of Medicine, St Louis, MO
| | - Ryan S. Jackson
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
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Lee HY, Abueva CD, Padalhin A, Park SY, Ryu HS, Chung PS, Kim HJ, Kim J, Woo SH. Regeneration of taste through sonic hedgehog upregulation by photobiomodulation. JOURNAL OF BIOPHOTONICS 2023; 16:e202300043. [PMID: 37483112 DOI: 10.1002/jbio.202300043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 07/25/2023]
Abstract
This study investigated photobiomodulation (PBM) effects in Sonic hedgehog (Shh) signaling as a potential approach to taste preservation and regeneration. Primary taste cell (TC) cultures were treated with Shh antagonist vismodegib and irradiated using a continuous wave type 630 nm light-emitting diode (10 mW/cm2 ) array, with single or multiple doses of 30 J/cm2 to determine dose inducing significant upregulation effect. Shh, Ptch, Smo, and Gli1 were significantly upregulated at 120 J/cm2 , used as the minimum dose in vivo. Vismodegib was administered via daily oral gavage for 21 days (30 mg/kg) to induce Shh inhibition in the tongue of rat animal models resulting in taste bud damage and taste dysfunction. PBM treatment using a 630 nm laser (3 W/cm2 ) at a radiant exposure of 120 J/cm2 (24 J/cm2 × 5) successfully upregulated the Shh protein expression, regenerated taste buds, and recovered taste function.
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Affiliation(s)
- Ha Young Lee
- Interdisciplinary Program for Medical Laser, Dankook University, Cheonan, Republic of Korea
| | - Celine Dg Abueva
- Dankook Institute of Medicine and Optics, Dankook University, Cheonan, Republic of Korea
| | - Andrew Padalhin
- Dankook Institute of Medicine and Optics, Dankook University, Cheonan, Republic of Korea
| | - So Young Park
- Dankook Institute of Medicine and Optics, Dankook University, Cheonan, Republic of Korea
| | - Hyun Seok Ryu
- Interdisciplinary Program for Medical Laser, Dankook University, Cheonan, Republic of Korea
| | - Phil-Sang Chung
- Dankook Institute of Medicine and Optics, Dankook University, Cheonan, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University Hospital, Cheonan, Republic of Korea
| | - Hee Jung Kim
- Department of Physiology, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Jeongyun Kim
- Department of Physics, Dankook University, Cheonan, Republic of Korea
| | - Seung Hoon Woo
- Dankook Institute of Medicine and Optics, Dankook University, Cheonan, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University Hospital, Cheonan, Republic of Korea
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Galaniha LT, Nolden AA. Taste loss in cancer patients: clinicians' perceptions of educational materials and diagnostic tools. Support Care Cancer 2023; 31:349. [PMID: 37222954 DOI: 10.1007/s00520-023-07794-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 05/02/2023] [Indexed: 05/25/2023]
Abstract
PURPOSE Cancer therapy is essential and lifesaving; however, it can have short- and long-term consequences on patients' health. Up to 87% of cancer patients report changes in taste function, yet patients report a lack of support from clinicians regarding their experience with taste loss during and following treatment. Thus, the objective of this study was to assess clinicians' knowledge and experience with managing patients with taste loss and identify potential gaps in the availability of educational materials and diagnostic tools. METHOD In an online survey, sixty-seven participants who identify as clinicians and practice in the United States and work with cancer patients that complain of taste problems answered questions on their knowledge and experience supporting cancer patients experiencing changes in taste function and provided their opinion on access to educational materials. RESULTS The current study reports gaps in participants' knowledge of taste and taste disorder terminology, with 15.4% correctly defining both taste and flavor and roughly half were familiar with specific taste disorder classifications. Over half of the participants reported not having access to adequate information to help their patients manage taste alterations. Only two-thirds of participants reported routinely asking patients if they are experiencing changes in taste function. CONCLUSION Clinicians' responses emphasized the need to improve access to educational materials regarding taste changes and increase the availability of information regarding management strategies. Addressing these inequities in education and improving the standard of care is the first step in improving the care for cancer patients suffering from altered taste function.
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Affiliation(s)
| | - Alissa A Nolden
- Department of Food Science, University of Massachusetts, Amherst, MA, 01003, USA.
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Mathlin J, Courtier N, Hopkinson J. Taste changes during radiotherapy for head and neck cancer. Radiography (Lond) 2023; 29:746-751. [PMID: 37224583 DOI: 10.1016/j.radi.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/12/2023] [Accepted: 05/03/2023] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Taste changes (dysgeusia) during radiotherapy for head and neck cancer are associated with malnutrition, tube feeding and reduced toleration of treatment. METHOD The MD Anderson symptom inventory - head and neck (MDASI-HN) questionnaire was completed by patients in a single department receiving radical radiotherapy or chemo-radiotherapy for head and neck cancer during weeks 1 and 4 of radiotherapy. Participants who developed dysgeusia in week 4 completed supplementary questions exploring what foods they could taste and how they managed taste changes. RESULTS At week 4, 97% of 61 participants reported taste changes, 77% reporting moderate or severe changes. 30% of participants reported taste changes during week 1. Patients with oropharyngeal, oral cavity and parotid gland tumours were most likely to develop dysgeusia. Females were more likely than males to report taste changes. A soft, semi-liquid diet was reportedly easier to tolerate as the more food was chewed the worse the taste became. CONCLUSIONS Patients having radiotherapy for all head and neck cancers should be warned of the very high risk of developing taste changes and the time scale for this. Patients with taste changes should be advised a softer diet requiring less chewing will be better tolerated. The finding that females are more at risk than males of dysgeusia needs further investigation. IMPLICATIONS FOR PRACTICE Patients with head and neck cancer should expect taste changes from the start of radiotherapy. Patients with dysgeusia should be advised that soft, semi-liquid foods that require less chewing before swallowing are easier to tolerate and that taste changes day-to-day.
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Affiliation(s)
- J Mathlin
- Radiotherapy Department, Velindre Cancer, Cardiff, CF14 2TL, UK.
| | - N Courtier
- School of Healthcare Sciences, Eastgate House, 35¬43 Newport Road, Cardiff, CF24 0AB, UK.
| | - J Hopkinson
- School of Healthcare Sciences, Cardiff University, 35-43 Newport Road, Cardiff, Wales, UK.
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Bernstein RT, Garner-Purkis A, Gallagher JE, Newland-Pedley, Scambler S. A systematic review of social impacts of treatment and rehabilitation of head and neck cancer patients. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2023. [DOI: 10.1016/j.adoms.2023.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Improving taste sensitivity in healthy adults using taste recall training: a randomized controlled trial. Sci Rep 2022; 12:13849. [PMID: 35974039 PMCID: PMC9379898 DOI: 10.1038/s41598-022-18255-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Although many patients suffer from taste disorder, methods to improve taste sensitivity are limited. To develop a taste recall training method to improve the perception of taste, 42 healthy individuals were randomly assigned to either the training or the control group. Using the filter paper disc method, participants in the training group were asked to match the four tastes (sweetness, saltiness, sourness, and bitterness) between those of taste recognition thresholds and those of a one-step higher concentration until they get them right. Then, they were asked to match the four tastes between those of one-step lower and one-step higher in concentration from their taste recognition thresholds until they get them right. Finally, they were asked to match the four tastes between those of one-step lower concentration and those of their taste recognition thresholds until they get them right. This training was repeated until perfectly matched. The taste recall training program led to a lowered taste recognition threshold in healthy adults for each taste quality, suggesting the improvement of taste sensitivity. This lowered threshold for each taste was observed with each additional training session. We conclude that this taste recall training method might be a therapeutic approach for treating taste disorder.
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The role of saliva in taste dysfunction among cancer patients: Mechanisms and potential treatment. Oral Oncol 2022; 133:106030. [PMID: 35868097 DOI: 10.1016/j.oraloncology.2022.106030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/21/2022] [Accepted: 07/15/2022] [Indexed: 01/17/2023]
Abstract
Two of the highest prevalent symptoms reported by cancer patients are taste dysfunction (17.6-93%) and dry mouth/xerostomia (40.4-93%). While it has been hypothesized that reduced saliva may impair taste function, few studies investigate the co-occurrence of taste and dry mouth symptoms in cancer patients. This review provides a summary of the physiological relationship between saliva and taste, focusing on taste transduction mechanism, regulation of the taste sensitivity, and protection of taste receptor cells, including the impact of cancer treatments and malignancy on saliva function, salivary components, and the mechanisms in which it can negatively impact the taste function. Here, the authors present a scoping review of the recent literature reporting on the association between taste dysfunction and dry mouth in cancer patients, including reports of non-pharmaceutical liposomal agents or drugs taken to improve dry mouth symptoms that also assess taste dysfunction. Considering the complexities of cancer and cancer treatment, understanding the physiological relationship between saliva and taste function may provide important insight into identifying treatments for alleviating taste dysfunction and dry mouth symptoms. There are substantial research gaps given the limited studies assessing the co-occurrence of taste loss and dry mouth and inconsistencies in the assessment of these symptoms. Clinical studies examining taste dysfunction will provide a foundational groundwork that will help understand the relationship between taste and saliva. Considering the increased rates in survivorship and the significant negative impact of taste dysfunction on quality of life, more research is needed to reduce the suffering of cancer patients.
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Chen WC, Hsu CM, Tsai YT, Lin MH, Tsai MS, Chang GH, Lai CH, Fang F, Chen MF. Prospective Evaluation of Taste Function in Patients With Head and Neck Cancer Receiving Intensity-Modulated Radiotherapy. JAMA Otolaryngol Head Neck Surg 2022; 148:604-611. [PMID: 35616981 PMCID: PMC9136673 DOI: 10.1001/jamaoto.2022.0850] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance The majority of the patients with head and neck cancer (HNC) experience taste dysfunction (TD) during or after radiotherapy (RT). However, prospectively collected data for taste dysfunction have been limited, especially in the era of intensity-modulated RT (IMRT). Objective To evaluate the taste function in patients with HNC receiving IMRT by investigating the association between time course and recovery of TD in both acute and late phases. Design, Setting, and Participants From August 2017 to November 2020, patients treated at the Chang Gung Memorial Hospital with curative or postoperative IMRT for HNC were enrolled in this prospective cohort study. The data analysis was performed from March 2021 to January 2022. Exposures IMRT with and without concurrent chemotherapy. Main Outcomes and Measures Taste function was measured using the whole-mouth solution method for 4 tastes (salt, sweet, sour, and bitter). Subjective evaluations (National Cancer Institute Common Terminology Criteria for Adverse Events [version 4.03] and Subjective Total Taste Acuity scale) were used. Patient self-reported quality of life was evaluated using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ-H&N35). Results A total of 87 patients (78 [90%] men and 9 [10%] women; mean [range] age, 58 [31-80] years) were enrolled. Overall TD rates were 79 of 86 (91.9%), 63 of 83 (75.9%), 27 of 81 (33.3%), 5 of 56 (8.9%), and 2 of 30 (6.7%) during RT, and 1 week, 3 months, 6 months, and 1 year after RT, respectively. Positive correlation occurred between objectively measured taste loss for the 4 taste qualities and subjective perception of taste loss. Only oral cavity mean dose 4000 cGy or greater predicted TD 3 months after RT. The mean oral cavity doses to the predicted 15% (D15), 25% (D25), and 50% (D50) probabilities were 25, 38, and 60 Gy at 3 months and 57, 60, and 64 Gy at 6 months, respectively. Conclusions and Relevance In this cohort study, most patients still experienced TD during and at 3 months after RT. Only a few patients experienced long-term TD. A high oral cavity dose was associated with TD in patients with HNC receiving IMRT. Reducing oral cavity dose may promote early recovery of taste function after IMRT.
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Affiliation(s)
- Wen-Cheng Chen
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan,College of Medicine, Chang Gung University, Tao-yuan, Taiwan
| | - Cheng-Ming Hsu
- Department of Otolaryngology–Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology–Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Meng-Hung Lin
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology–Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Geng-He Chang
- Department of Otolaryngology–Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chia-Hsuan Lai
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Fumin Fang
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Miao-Fen Chen
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan,College of Medicine, Chang Gung University, Tao-yuan, Taiwan,Graduate Institute of Clinical Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Nabarrete JM, Pereira AZ, Garófolo A, Seber A, Venancio AM, Grecco CES, Bonfim CMS, Nakamura CH, Fernandes D, Campos DJ, Oliveira FLC, Cousseiro FK, Rossi FFP, Gurmini J, Viani KHC, Guterres LF, Mantovani LFAL, Darrigo LG, Albuquerque MIBPE, Brumatti M, Neves MA, Duran N, Villela NC, Zecchin VG, Fernandes JF. Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: children and adolescents. EINSTEIN-SAO PAULO 2021; 19:eAE5254. [PMID: 34909973 PMCID: PMC8664291 DOI: 10.31744/einstein_journal/2021ae5254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 12/10/2020] [Indexed: 11/28/2022] Open
Abstract
The Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Children and Adolescents was developed by dietitians, physicians, and pediatric hematologists from 10 Brazilian reference centers in hematopoietic stem cell transplantation. The aim was to emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to patient´s nutritional assessment. This consensus is intended to improve and standardize nutrition therapy during hematopoietic stem cell transplantation. The consensus was approved by the Brazilian Society of Bone Marrow Transplantation.
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Affiliation(s)
- Juliana Moura Nabarrete
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Andrea Z Pereira
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Adriana Garófolo
- Universidade Federal de São PauloInstituto de Oncologia PediátricaSão PauloSPBrazilInstituto de Oncologia Pediátrica, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Adriana Seber
- Universidade Federal de São PauloSão PauloSPBrazilUniversidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Angela Mandelli Venancio
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Carlos Eduardo Setanni Grecco
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoHospital das ClínicasRibeirão PretoSPBrazilHospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Carmem Maria Sales Bonfim
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Claudia Harumi Nakamura
- Universidade Federal de São PauloInstituto de Oncologia PediátricaSão PauloSPBrazilInstituto de Oncologia Pediátrica, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Daieni Fernandes
- Santa Casa de Misericórdia de Porto AlegrePorto AlegreRSBrazilSanta Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Denise Johnsson Campos
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Fernanda Luisa Ceragioli Oliveira
- Universidade Federal de São PauloEscola Paulista de MedicinaSão PauloSPBrazilEscola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Flávia Krüger Cousseiro
- Santa Casa de Misericórdia de Porto AlegrePorto AlegreRSBrazilSanta Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Flávia Feijó Panico Rossi
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Jocemara Gurmini
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Karina Helena Canton Viani
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrazilInstituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Luciana Fernandes Guterres
- Santa Casa de Misericórdia de Porto AlegrePorto AlegreRSBrazilSanta Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | | | - Luiz Guilherme Darrigo
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoHospital das ClínicasRibeirão PretoSPBrazilHospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Maria Isabel Brandão Pires e Albuquerque
- Instituto Nacional de Câncer José Alencar Gomes da SilvaRio de JaneiroRJBrazilInstituto Nacional de Câncer José Alencar Gomes da Silva - INCA, Rio de Janeiro, RJ, Brazil.
| | - Melina Brumatti
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Mirella Aparecida Neves
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Natália Duran
- Hospital de Câncer de BarretosBarretosSPBrazilHospital de Câncer de Barretos, Barretos, SP, Brazil.
| | - Neysimelia Costa Villela
- Hospital de Câncer de BarretosBarretosSPBrazilHospital de Câncer de Barretos, Barretos, SP, Brazil.
| | - Victor Gottardello Zecchin
- Universidade Federal de São PauloInstituto de Oncologia PediátricaSão PauloSPBrazilInstituto de Oncologia Pediátrica, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Juliana Folloni Fernandes
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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12
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Factors associated with unintentional weight loss among older adults in a geriatric outpatient clinic of university hospital. PLoS One 2021; 16:e0260233. [PMID: 34793549 PMCID: PMC8601429 DOI: 10.1371/journal.pone.0260233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/04/2021] [Indexed: 12/28/2022] Open
Abstract
Background Unintentional weight loss (UWL) is defined as unintentional reduction of more than 5% of baseline body weight over 6 to 12 months. UWL is a common problem in the older adults, resulting in increased rate of morbidity and mortality. With specific reference to Thailand, no information on factors associated with UWL in older adults could be traced. The aims of this research were to identify the factors associated with UWL and to assess the common causes of UWL among older adults in the geriatric outpatient clinic of university hospital. Methods A case-control study was conducted from June 1st, 2020 to December 31st, 2020. Eighty older adults aged 60 years or older were enrolled in the UWL group while the non-UWL group consisted of 160 participants. Data collection was performed by structural questionnaire including baseline characteristics, psychosocial factors, health information, lifestyle behaviors, and medications. The factors associated with UWL were analyzed by using univariate and multivariate logistic regression analysis. Causes of UWL were recorded from electronic medical records. Results The mean age of the 240 participants was 79.6 years (SD 7.4). Most patients were female (79.2%) and had fewer than 12 years of education (62.6%). The three common causes of UWL were reduced appetite (20.1%), dementia and behavioral and psychological symptoms of dementia (13.7%) and medications (11.0%). Multivariate logistic regression analysis showed that a Charlson Comorbidity Index (CCI) score of >1 (OR 2.55, 95% CI 1.37–4.73; P = 0.003), vitamin D deficiency (OR 4.01, 95% CI 1.62–9.97; P = 0.003), and hemoglobin level of <12 g/dL (OR 2.47, 95% CI 1.32–4.63; P = 0.005) were factors significantly associated with UWL. Conclusions Factors associated with UWL were CCI score >1, vitamin D deficiency, and hemoglobin level of <12 g/dl. The early detection of these associated factors, reduced appetite, dementia and polypharmacy may be important in UWL prevention in older adults.
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de Oliveira Faria S, Hurwitz G, Kim J, Liberty J, Orchard K, Liu G, Barbera L, Howell D. Identifying Patient-Reported Outcome Measures (PROMs) for Routine Surveillance of Physical and Emotional Symptoms in Head and Neck Cancer Populations: A Systematic Review. J Clin Med 2021; 10:jcm10184162. [PMID: 34575271 PMCID: PMC8470145 DOI: 10.3390/jcm10184162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
The aims of this review were to identify symptoms experienced by head and neck cancer (HNC) patients and their prevalence, as well as to compare symptom coverage identified in HNC specific patient-reported outcome measures (PROMs). Searches of Ovid Medline, Embase, PsychInfo, and CINAHL were conducted to identify studies. The search revealed 4569 unique articles and identified 115 eligible studies. The prevalence of reported symptoms was highly variable among included studies. Variability in sample size, timing of the assessments, and the use of different measures was noted across studies. Content mapping of commonly used PROMs showed variability and poor capture of prevalent symptoms, even though validation studies confirmed satisfactory reliability and validity. This suggests limitations of some of the tools in providing an accurate and comprehensive picture of the patient's symptoms and problems.
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Affiliation(s)
- Sheilla de Oliveira Faria
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
- Correspondence: ; Tel.: +55-11-3061-8278
| | - Gillian Hurwitz
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Jaemin Kim
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Jacqueline Liberty
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Kimberly Orchard
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Geoffrey Liu
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
- Dalla Lana School of Public Health, Toronto, ON M5T 3M7, Canada
- Temerty Faculty of Medicine, Toronto, ON M5S 1A8, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Lisa Barbera
- Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
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14
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Boscutti A, Delvecchio G, Pigoni A, Cereda G, Ciappolino V, Bellani M, Fusar-Poli P, Brambilla P. Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review. Brain Behav Immun Health 2021; 15:100268. [PMID: 34027497 PMCID: PMC8129998 DOI: 10.1016/j.bbih.2021.100268] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Among Coronavirus Disease 2019 (COVID-19) manifestations, Olfactory (OD) and Gustatory (GD) Dysfunctions (OGD) have drawn considerable attention, becoming a sort of hallmark of the disease. Many have speculated on the pathogenesis and clinical characteristics of these disturbances; however, no definite answers have been produced on the topic. With this systematic review, we aimed to collect all the available evidence regarding the prevalence of OGD, the timing of their onset and their resolution, their rate of recovery and their role as diagnostic and prognostic tools for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. METHODS A systematic review comprising all the observational studies that reported the prevalence and/or the longitudinal trajectories of OGD in COVID-19 patients, as self-reported by patients or measured through objective psychophysical tests. RESULTS After the selection process, 155 studies were included, with a total of 70,920 patients and 105,291 not-infected individuals. Prevalence reports were extremely variable across studies, with wide ranges for OD (0%-98%) and GD (0-89%) prevalence. OGD occurred early during the disease course and only rarely preceded other symptoms; out of 30 studies with a follow-up time of at least 20 days, only in 5 studies OGD fully resolved in more than 90% of patients. OGD had low sensitivity and high specificity for SARS-CoV-2 infection; accuracy of OD and GD for infection identification was higher than 80% in 10 out of 33 studies and in 8 out of 22 studies considered, respectively. 28 out of 30 studies that studied the association between OGD and disease severity found how OGD were associated with lower rates of severe pneumonia, hospitalization and mortality. CONCLUSIONS OGD seem to be highly prevalent in SARS-CoV-2 infection. They occur early, concomitantly with other symptoms and often persist after recovery, in some cases for months; whether a full recovery eventually occurs in all cases is not clear yet. OGD are good predictors of SARS-CoV-2 infection and are associated with a milder disease course.
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Affiliation(s)
- A. Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - G. Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - A. Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - G. Cereda
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - V. Ciappolino
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
| | - M. Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
- UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata, Verona (AOUI), Italy
| | - P. Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - P. Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
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15
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Alfaro R, Crowder S, Sarma KP, Arthur AE, Pepino MY. Taste and Smell Function in Head and Neck Cancer Survivors. Chem Senses 2021; 46:6288444. [PMID: 34050750 DOI: 10.1093/chemse/bjab026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Survivors of head and neck squamous cell cancers (HNSCC) frequently complain of taste dysfunction long after radiation therapy is completed, which contradicts findings from most sensory evaluation studies that predict dysfunction should resolve few months after treatment. Therefore, it remains unclear whether taste and smell function fully recovers in HNSCC survivors. We evaluated HNSCC survivors (n = 40; age 63 ± 12 years, mean ± standard deviation) who received radiation therapy between 6 months and 10 years before recruitment and compared their responses to those of a healthy control group (n = 20) equivalent in age, sex, race, smoking history, and body mass index. We assessed regional (tongue tip) and whole-mouth taste intensity perception using the general Labeled Magnitude Scale and smell function using the University of Pennsylvania Smell Identification Test (UPSIT). To determine possible differences between groups in retronasal smell perception, we used solutions of sucrose with strawberry extract, citric acid with lemon extract, sodium chloride in vegetable broth, and caffeine in coffee and asked participants to rate perceived smell and taste intensities with and without nose clips. We found groups had similar UPSIT and taste intensity scores when solutions were experienced in the whole mouth. However, HNSCC survivors were less likely to identify low concentrations of bitter, sweet, or salty stimuli in the tongue tip relative to healthy controls. Our findings suggest persistent and subtle localized damage to the chorda tympani or to the taste buds in the fungiform papillae of HNSCC survivors, which could explain their sensory complaints long after completion of radiotherapy.
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Affiliation(s)
- Raul Alfaro
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 905 South Goodwin Avenue, Urbana, IL 61820, USA
| | - Sylvia Crowder
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 905 South Goodwin Avenue, Urbana, IL 61820, USA
| | - Kalika P Sarma
- Carle Foundation Hospital, 509 West University Avenue, Urbana, IL 61820, USA
| | - Anna E Arthur
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 905 South Goodwin Avenue, Urbana, IL 61820, USA.,Carle Foundation Hospital, 509 West University Avenue, Urbana, IL 61820, USA.,Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, 1201 West Gregory Drive, Urbana, IL 61820, USA
| | - Marta Yanina Pepino
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 905 South Goodwin Avenue, Urbana, IL 61820, USA.,Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, 1201 West Gregory Drive, Urbana, IL 61820, USA
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16
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Messing BP, Ward EC, Lazarus C, Ryniak K, Maloney J, Thompson CB, Kramer E. Longitudinal comparisons of a whole-mouth taste test to clinician-rated and patient-reported outcomes of dysgeusia postradiotherapy in patients with head and neck cancer and associations with oral intake. Head Neck 2021; 43:2159-2177. [PMID: 33856086 DOI: 10.1002/hed.26690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 02/25/2021] [Accepted: 03/16/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND After head and neck cancer (HNC) treatment, dysgeusia may be a barrier to oral intake. In this exploratory study, we prospectively examined taste perception, clinician-rated (CRO) and patient-reported (PRO) taste changes and their effect on oral intake postradiotherapy. METHODS Twenty-eight patients were assessed at baseline, treatment weeks 2 and 4, and 1, 3, and 6 months post-treatment using a whole-mouth taste test and associated CRO and subjective PRO measures. RESULTS Greater taste impairment was reflected by subjective than by a whole-mouth taste test. The most significant and consistent decline occurred mid-treatment. The Chemotherapy-Induced Taste Alteration Scale (PRO) discomfort subscale correlated significantly with maintaining an oral diet, percent of oral intake, and appetite level from mid-treatment to 6 months post-treatment. CONCLUSIONS PRO results indicated ongoing oral intake issues. Whole-mouth taste tests may fail to fully reflect functional taste-loss. Dysgeusia prevention and treatment methods are needed to improve patient outcomes.
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Affiliation(s)
- Barbara Pisano Messing
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Head & Neck Surgery, Johns Hopkins Voice Center at GBMC, Baltimore, Maryland, USA.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Centre for Functioning and Health Research, Metro South Hospital and Health Service, Queensland Government, Brisbane, Queensland, Australia
| | - Cathy Lazarus
- Department of Otolaryngology - Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, Thyroid Head and Neck Research Center, Thyroid Head and Neck Cancer (THANC) Foundation, Mount Sinai Beth, Israel
| | - Keri Ryniak
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Head & Neck Surgery, Johns Hopkins Voice Center at GBMC, Baltimore, Maryland, USA
| | - Jessica Maloney
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Head & Neck Surgery, Johns Hopkins Voice Center at GBMC, Baltimore, Maryland, USA
| | - Carol B Thompson
- Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elizabeth Kramer
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Head & Neck Surgery, Johns Hopkins Voice Center at GBMC, Baltimore, Maryland, USA
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17
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Gunn L, Gilbert J, Nenclares P, Soliman H, Newbold K, Bhide S, Wong KH, Harrington K, Nutting C. Taste dysfunction following radiotherapy to the head and neck: A systematic review. Radiother Oncol 2021; 157:130-140. [PMID: 33545253 DOI: 10.1016/j.radonc.2021.01.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND An intact sense of taste provides pleasure, supports sustenance and alerts the body to toxins. Head and neck cancer (HNC) patients who receive radiotherapy (RT) are high-risk for developing radiation-induced taste dysfunction. Advances in RT offer opportunities for taste-preserving strategies by reducing dose to the gustatory organs-at-risk. METHODS PubMed, Medline and EMBASE were searched for publications reporting on taste, RT and HNC. Randomised trials, cohort studies and cross-sectional studies were included. RESULTS 31 studies were included in this review. Meta-analysed prevalence of acute taste dysfunction following RT was approximately 96% (95% CI 64 to 100%) by objective measures and 79% (95% CI 65 to 88%) by subjective measures, with the majority of patients showing at least partial recovery. Long-term dysfunction was seen in ~25% of patients. Taste dysfunction was associated with sequalae including weight loss and reduced quality-of-life (QoL). Taste dysfunction was more common when the oral cavity, and specifically the anterior two-thirds of the tongue, was irradiated, suggesting a dose constraint for taste preservation might be feasible. Proton beam therapy and customised bite blocks reduced dose to the gustatory field and subsequent loss of taste. CONCLUSIONS Taste dysfunction following RT is common and negatively affects patients' nutritional status and QoL. Decisions about treatment strategies, including choice of RT modality, dose distribution across the gustatory field and the use of adjuncts like bite blocks may be beneficial. However, evidence is limited. There is a pressing need for randomised studies or large prospective cohort studies with sufficient adjustment for confounders.
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Affiliation(s)
- Lucinda Gunn
- Head and Neck Unit, The Royal Marsden London, London, UK.
| | | | | | - Heba Soliman
- Head and Neck Unit, The Royal Marsden London, London, UK
| | - Kate Newbold
- Head and Neck Unit, The Royal Marsden London, London, UK; Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Shree Bhide
- Head and Neck Unit, The Royal Marsden London, London, UK; Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Kee Howe Wong
- Head and Neck Unit, The Royal Marsden London, London, UK
| | - Kevin Harrington
- Head and Neck Unit, The Royal Marsden London, London, UK; Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Chris Nutting
- Head and Neck Unit, The Royal Marsden London, London, UK; Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
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18
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Chi WJ, Myers JN, Frank SJ, Aponte-Wesson RA, Otun AO, Nogueras-González GM, Li Y, Geng Y, Chambers MS. The effects of zinc on radiation-induced dysgeusia: a systematic review and meta-analysis. Support Care Cancer 2020; 28:1-12. [PMID: 32642950 DOI: 10.1007/s00520-020-05578-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/12/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Many head and neck cancer patients who receive radiation therapy experience radiation-induced dysgeusia (RID), which has no standard treatment. The only supplement controlled clinical trials have evaluated for the treatment of RID is zinc. However, the results of these and other studies investigating the use of zinc for RID have been inconsistent. To assess the validity of zinc as a treatment for RID, we conducted a systematic literature search and performed a meta-analysis to determine the extent to which zinc affects RID incidence and the degree to which ongoing RID responds to zinc. METHODS We searched the Ovid MEDLINE, Ovid Embase, PubMed, and Cochrane Library databases to identify studies investigating the use of zinc-based therapy for RID in head and neck cancer patients treated with radiation that were published between January 1, 2003, and November 9, 2017. Using American Society of Clinical Oncology criteria, we selected studies with a high level of evidence for inclusion in the meta-analysis. RESULTS Of the 32 full-text articles eligible for inclusion, three were included in the final review and meta-analysis. The meta-analysis showed that, compared with placebo, zinc reduces the incidence of RID (risk ratio, 0.72; 95% confidence interval, 0.67-0.92) but does not improve taste acuity more rapidly following radiation therapy (risk ratio, 2.58; 95% confidence interval, 0.97-6.88). CONCLUSION Our findings indicate that zinc-based therapy reduces the incidence of RID but has a minimal effect on ongoing RID. Our findings also highlight the need for additional evidence-based research on this topic.
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Affiliation(s)
- Woo J Chi
- Department of Hospital Dentistry, Walter Reed National Military Medical Center, Bethesda, MD, USA.
| | - Jeffrey N Myers
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ruth A Aponte-Wesson
- Section of Oral Oncology and Maxillofacial Prosthodontics, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Adegbenga O Otun
- Section of Oral Oncology and Maxillofacial Prosthodontics, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yimin Geng
- Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mark S Chambers
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Section of Oral Oncology and Maxillofacial Prosthodontics, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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19
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Stieb S, Mohamed ASR, He R, Zhu LL, McDonald BA, Wahid K, van Dijk LV, Ventura J, Ahmed S, McCoy L, Deshpande TS, Grant S, Reddy JP, Phan J, Garden AS, Rosenthal DI, Frank SJ, Gunn GB, Fuller CD. Development and validation of a contouring guideline for the taste bud bearing tongue mucosa. Radiother Oncol 2020; 157:63-69. [PMID: 33217499 DOI: 10.1016/j.radonc.2020.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To introduce a contouring guideline for the taste bud bearing tongue mucosa for head and neck cancer patients receiving radiotherapy. METHODS AND MATERIALS CT simulation images of oropharyngeal cancer patients were used to delineate both the whole tongue (extrinsic/intrinsic tongue muscles, floor of mouth) and the taste bud bearing tongue mucosa (method A: adaptation of the whole tongue structure; method B: axial adaptation of a mid-sagittal contour). Volumetric and dosimetric parameters of the whole tongue and the two methods of mucosal delineation, spatial overlap between methods A and B, and inter-observer variability for method B were calculated. RESULTS The study cohort was comprised of 70 patients with T1-4 N0-1 tonsillar (83%) and base of tongue (17%) cancers. Most of the comparative parameters between the whole tongue and mucosa (method A) significantly differed (mean, minimum, and maximum dose, V5-V70, D40-D90). The mean dose calculated for the whole tongue deviated on average 3.77 Gy compared to method A. No significant differences were found between methods A and B of the taste bud bearing tongue mucosa structure, and none of the dosimetric parameters differed more than 1.03 Gy on average. The mean Dice similarity coefficient for both mucosal structures was 0.79 ± 0.05, and 0.63 ± 0.12 for the inter-observer analysis of method B. CONCLUSIONS We defined two methods for delineating the taste bud bearing mucosa and both are equally satisfactory procedures. Either method is preferable over delineation of the whole tongue as organ at risk for taste impairment.
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Affiliation(s)
- Sonja Stieb
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Renjie He
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Lin L Zhu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Brigid A McDonald
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Kareem Wahid
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Lisanne V van Dijk
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Juan Ventura
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Sara Ahmed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Lance McCoy
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Tanaya S Deshpande
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Stephen Grant
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Jay P Reddy
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Jack Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Adam S Garden
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - C David Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
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20
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Choi JH, Kim MJ, Kho HS. Oral health-related quality of life and associated factors in patients with burning mouth syndrome. J Oral Rehabil 2020; 48:150-159. [PMID: 33031643 DOI: 10.1111/joor.13110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 09/19/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The purpose of this study was to assess oral health-related quality of life (OHRQoL) in patients with burning mouth syndrome (BMS) and to identify clinical factors associated with OHRQoL. METHODS Fifty-seven patients with BMS (56.4 ± 10.7 years) participated in the study. Patients underwent oral examination, laboratory tests, psychological evaluation, measurement of salivary flow rates and evaluation of clinical characteristics using a BMS questionnaire. The OHRQoL of patients was assessed using the Oral Health Impact Profile-14 (OHIP-14). RESULTS The OHIP-14 score for patients with BMS was 38.6 ± 12.8. Patients had higher scores for the psychological discomfort and physical pain dimensions of the OHIP-14. The intensity of taste disturbance or xerostomia symptoms (β = 0.464, P < .001), worry about symptoms (β = 0.307, P = .020), and results of psychological evaluation (β = 0.311, P = .026) were significantly associated with OHIP-14 score. Multiple linear regression showed that the intensity of taste disturbance or xerostomia symptoms was significantly associated with decreased OHRQoL (β = 0.637, P = .026). CONCLUSIONS This study suggests that severity of taste disturbance or xerostomia is an important factor that influences OHRQoL in patients with BMS.
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Affiliation(s)
- Jee-Hye Choi
- Department of Dental Hygiene, Yonsei University Graduate School, Seoul, Korea
| | - Moon-Jong Kim
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Hong-Seop Kho
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea.,Institute on Aging, Seoul National University, Seoul, Korea
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21
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Chen WC, Tsai MS, Tsai YT, Lai CH, Lee CP, Chen MF. Long-Term Taste Impairment after Intensity-Modulated Radiotherapy to Treat Head-and-Neck Cancer: Correlations with Glossectomy and the Mean Radiation Dose to the Oral Cavity. Chem Senses 2020; 44:319-326. [PMID: 30957861 DOI: 10.1093/chemse/bjz018] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We explored the effects of various parameters on taste impairments (TIs) in head-and-neck (H&N) cancer patients receiving intensity-modulated radiotherapy (IMRT). From January 2014 to September 2017, 88 H&N cancer patients subjected to curative or postoperative IMRT were enrolled in this prospective study. All patients underwent at least 1 year of follow-up after IMRT. Quality-of-life assessments in terms of patient-reported gustatory function were measured using the taste-related questions of the European Organization for Research and Treatment of Cancer H&N35 questionnaires. At a median follow-up time of 27 months, 27 of 88 patients (30.7%) reported long-term TIs. In multivariate analyses, glossectomy most significantly predicted TIs (P = 0.04). The percentage of TIs (61.5%) was significantly (P = 0.03) higher in patients who underwent partial or total glossectomy than in patients who did not undergo surgery (28.0%) and those who underwent radical surgery without glossectomy (20.0%). When we excluded surgical patients from analyses, the mean radiation dose to the oral cavity was of borderline significance in terms of TI prediction (P = 0.05). Only 10.5% of patients suffered from TIs when the mean radiation dose was <5000 cGy compared with 38.7% when the mean dose was ≥5000 cGy. In conclusion, glossectomy is the major cause of long-term TIs in H&N cancer patients receiving IMRT. In patients who do not undergo glossectomy, reduction of the mean radiation dose to the oral cavity may reduce TIs after IMRT.
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Affiliation(s)
- Wen-Cheng Chen
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Tao-yuan, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chia-Hsuan Lai
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chuan-Pin Lee
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Miao-Fen Chen
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Tao-yuan, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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22
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Saadoun R, Obermueller T, Franke M, Schell A, Mückner K, Riemann R. Leiomyosarcoma of the Nasal Cavity. EAR, NOSE & THROAT JOURNAL 2020; 101:NP218-NP221. [PMID: 32951455 DOI: 10.1177/0145561320961204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Leiomyosarcoma (LMS) in the sinonasal tract (SNT) is a rarity that has been firstly described in 1958. Since then, there have been only a few articles about this entity. Most of the data available about LMS in the SNT is derived from case reports. We believe that our case will support the data set and help guiding the management of this rare condition. A 84-year-old female presented with nasal airway obstruction on the left side. She experienced several episodes of epistaxis from her left nostril, what made her to seek medical care. A rhinoscopy revealed an obstructing mass in the left nasal cavity. Computed tomography (CT) scan of the paranasal sinuses revealed a homogenous mass occupying the left nasal cavity, bone destruction of the left middle, and inferior nasal turbinates. An infiltration of the left nasolacrimal duct was also present. The patient refused to undergo open surgery and the mass was removed during an endoscopic approach. The histopathological analysis combined with immunohistochemistry was consistent with LMS. The resection margins were positive for tumor cells. A staging with CT-neck-thorax, abdomen ultrasound, and MRI of the head ruled out metastases. She underwent a second endoscopic tumor resection surgery with positive resection margins and obtained adjuvant radiotherapy. On 9 months of follow-up, there was no recurrence or metastases.
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Affiliation(s)
- Rakan Saadoun
- Department of Otorhinolaryngology Head and Neck Surgery, Elbe Klinikum Stade, Stade, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Mannheim, Germany
| | - Theresa Obermueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institutes of Health, Berlin, Germany
| | - Mareike Franke
- Diagnostic and Interventional Radiology, Dr. Hancken Clinic, Stade, Germany
| | - Angela Schell
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Mannheim, Germany
| | - Kersten Mückner
- Diagnostic and Interventional Radiology, Dr. Hancken Clinic, Stade, Germany
| | - Randolf Riemann
- Department of Otorhinolaryngology Head and Neck Surgery, Elbe Klinikum Stade, Stade, Germany
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23
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Stieb S, Perez-Martinez I, Mohamed AS, Rock S, Bajaj N, Deshpande TS, Zaid M, Garden AS, Goepfert RP, Cardoso R, Ferrarotto R, Reddy JP, Phan J, Morrison WH, Rosenthal DI, Koay EJ, Frank SJ, Fuller CD, Gunn GB. The impact of tongue-deviating and tongue-depressing oral stents on long-term radiation-associated symptoms in oropharyngeal cancer survivors. Clin Transl Radiat Oncol 2020; 24:71-78. [PMID: 32642562 PMCID: PMC7334797 DOI: 10.1016/j.ctro.2020.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES To evaluate whether the use of oral stents during intensity modulated radiation therapy (IMRT) for oropharyngeal cancer (OPC) is associated with long-term patient reported symptoms. MATERIALS AND METHODS Data was obtained from a prospective observational study of disease-free head and neck cancer survivors. Radiation-associated patient reported symptoms were assessed using the MD Anderson Symptom Inventory Head and Neck module (MDASI-HN). Scores of ≥5 (11-point Likert scale, 0-10) were considered moderate/severe. Stratification was performed regarding IMRT volume (uni- versus bilateral neck) and stent utilization, with non-parametric analyses between groups. RESULTS 462 OPC survivors formed the cohort (54% tonsil, 46% base of tongue primaries). A tongue-deviating stent was used in 17%, tongue-depressing stent in 46%, and no stent in 37%. Median prescribed dose to the high dose clinical target volume was 66.0 Gy. Median follow-up from RT to MDASI-HN assessment was 68 months. Twenty percent had received unilateral neck RT (all had tonsil primaries), in whom a significant improvement in the proportion of patients with moderate/severe taste impairment (2% vs. 15%, p = 0.047) and lack of appetite (0% vs. 9%, p = 0.019) was associated with the use of tongue-deviating stents compared to no oral stent. In those who had received bilateral neck RT, a significant improvement in the proportion of patients with moderate/severe difficulty swallowing/chewing was associated with use of a tongue-depressing stent (21% vs. 31% without oral stent, p = 0.013). CONCLUSION Disease-site specific select use of oral stents during IMRT was associated with reduced long-term patient reported symptoms in OPC survivors.
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Affiliation(s)
- Sonja Stieb
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Ismael Perez-Martinez
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Abdallah S.R. Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Stockton Rock
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Nimit Bajaj
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Tanaya S. Deshpande
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Mohamed Zaid
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Adam S. Garden
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Ryan P. Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Richard Cardoso
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Renata Ferrarotto
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Jay P. Reddy
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Jack Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - William H. Morrison
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - David I. Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Eugene J. Koay
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Steven J. Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - C. David Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - G. Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - MD Anderson Head and Neck Cancer Symptom Working Group
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
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24
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Galaniha LT, McClements DJ, Nolden A. Opportunities to improve oral nutritional supplements for managing malnutrition in cancer patients: A food design approach. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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25
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Enriquez-Fernandez BE, Martinez-Michel L, Thorlakson J, Wismer WV. Patient-reported taste change assessment questionnaires used in the oncology setting: A narrative review. Eur J Oncol Nurs 2020; 47:101775. [PMID: 32559713 DOI: 10.1016/j.ejon.2020.101775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Patient-reported questionnaires to assess taste changes (TC) among patients with cancer and the common domains or aspects assessed by those questionnaires are identified in this narrative review. Taste changes are a prevalent symptom experienced by patients with cancer that impact food choice and enjoyment, reduce food intake, and diminish quality of life. Appropriate assessment is essential to detect and manage this symptom. METHOD A systematic search of relevant databases between 1999 and 2018 yielded 1959 articles; 38 articles were included in the review. RESULTS Seventeen questionnaires designed specifically to assess patient-reported taste changes among patients with cancer are described in the review. Seven domains were identified among the questionnaires; the most frequently assessed domain was the description of the taste change in 14 questionnaires). Timeframe, scoring, number of items and domains, and item phrasing varied greatly among questionnaires and the approach to domain and item evaluation was inconsistent. Comprehensive questionnaires (n = 7) assessed five or more domains to characterize the taste change experience. The majority of questionnaires have been cited only once or twice. CONCLUSION Patient-reported taste change assessment in oncology has been achieved by a large number of diverse questionnaires; no standard tool or approach is used. Development of a question bank of validated or standardized taste change modules or items may strengthen the consistency and applicability of research in this area.
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26
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Prospective assessment of gustatory function after radiotherapy for head and neck cancers. Eur Arch Otorhinolaryngol 2020; 277:2745-2751. [PMID: 32449027 DOI: 10.1007/s00405-020-06051-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Taste disorders are major causes of morbidity in patients undergoing head and neck irradiation. We quantitatively assessed the gustatory function of patients with head and neck cancers who underwent radiotherapy using recently developed standardised tools for measuring taste. METHODS Twenty patients undergoing head and neck irradiation responded to a specific questionnaire and were assessed by olfactory and gustatory function tests. To assess changes over time, testing was performed before, immediately after, and at 2- and 4-week intervals following the start of radiotherapy. Concurrently, patients were evaluated for xerostomia from radiotherapy. RESULTS A decrease in the taste recognition threshold was observed in the second week after the beginning of radiotherapy. The taste detection threshold improved within the 14th-18th week. Most affected patients demonstrated that their gustatory function primarily decreased independent of the olfactory function. Disturbances in taste were exponentially worsened beyond an accumulated dose of 30 Gy and involved all tastants. According to a multivariate analysis, radiation-induced taste impairment was not influenced by the degree of xerostomia. However, there was an association between the dose of irradiation and the severity of taste disturbance. CONCLUSIONS In this preliminary study, we found that the taste function was worse 2 weeks after the start of radiotherapy and returned to pretreatment levels within 4.5 months. Taste disturbances were exponentially worse beyond an accumulated dose of 20 Gy. Taste dysfunction after radiotherapy was not influenced by the degree of xerostomia, whereas only the dose of irradiation was associated with the severity of taste dysfunction.
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27
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Dilalla V, Chaput G, Williams T, Sultanem K. Radiotherapy side effects: integrating a survivorship clinical lens to better serve patients. Curr Oncol 2020; 27:107-112. [PMID: 32489253 PMCID: PMC7253739 DOI: 10.3747/co.27.6233] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The Canadian Cancer Society estimated that 220,400 new cases of cancer would be diagnosed in 2019. Of the affected patients, more than 60% will survive for 5 years or longer after their cancer diagnosis. Furthermore, nearly 40% will receive at least 1 course of radiotherapy (rt). Radiotherapy is used with both curative and palliative intent: to treat early-stage or locally advanced tumours (curative) and for symptom management in advanced disease (palliative). It can be delivered systemically (external-beam rt) or internally (brachytherapy). Although technique improvements have drastically reduced the occurrence of rt-related toxicity, most patients still experience burdensome rt side effects (seffs). Radiotherapy seffs are local or locoregional, and manifest in tissues or organs that were irradiated. Side effects manifesting within weeks after rt completion are termed "early seffs," and those occurring months or years after treatment are termed "late seffs." In addition to radiation oncologists, general practitioners in oncology and primary care providers are involved in survivorship care and management of rt seffs. Here, we present an overview of common seffs and their respective management: anxiety, depression, fatigue, and effects related to the head-and-neck, thoracic, and pelvic treatment sites.
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Affiliation(s)
- V Dilalla
- Division of Radiation Oncology, McGill University, Montreal, QC
| | - G Chaput
- Department of Family Medicine (Secondary Care), Division of Supportive and Palliative Medicine, McGill University Health Centre, and McGill University, Montreal, QC
| | - T Williams
- Cancer Care Mission Patients' Committee, McGill University Health Centre, Montreal, QC
| | - K Sultanem
- Department of Oncology, Division of Radiation Oncology, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC
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28
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Loves R, Plenert E, Tomlinson V, Palmert S, Green G, Schechter T, Tomlinson D, Vettese E, Zupanec S, Dupuis LL, Sung L. Changes in hunger among pediatric patients with cancer and hematopoietic stem cell transplantation recipients. Support Care Cancer 2020; 28:5795-5801. [PMID: 32219569 DOI: 10.1007/s00520-020-05425-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 03/19/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE Change in hunger is a common and bothersome symptom among pediatric patients receiving cancer treatments. Objectives were to describe how children and adolescents receiving cancer treatments experience changes in hunger, factors associated with both increases and decreases in hunger, and coping strategies used by these patients. METHODS We enrolled children and adolescents 4-18 years of age with cancer or hematopoietic stem cell transplantation (HSCT) recipients who were actively receiving treatment or who had completed therapy. Using a single, qualitative, semi-structured interview, we asked participants about the experience of increases or decreases in hunger, including characteristics of the change and identified coping strategies. RESULTS There were 50 children enrolled; 25 (50%) were 4-10 years of age and 33 (66%) were boys. Most often, patients associated an increase in hunger with corticosteroid administration, while other treatments, accompanying symptoms, inactivity, and the hospital environment were associated with a decrease in hunger. Many reported that no coping strategies were successful. For those who did report successful strategies to manage an increase in hunger, these included sleep and having food available. Strategies used to manage a decrease in hunger included anti-emetic medications, increased caloric intake, varied food choices, encouragement to eat, scheduling or tracking of meals, and physical activity. CONCLUSIONS Both increases and decreases in hunger were commonly described. Some coping strategies were reported to be successful. Further research should identify and test interventions to manage changes in hunger in pediatric cancer patients.
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Affiliation(s)
- Robyn Loves
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
| | - Erin Plenert
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
| | - Vivian Tomlinson
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
| | - Sasha Palmert
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
| | - Gloria Green
- Division of Clinical Dietetics, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
- Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
| | - Tal Schechter
- Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
| | - Deborah Tomlinson
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
| | - Emily Vettese
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
| | - Sue Zupanec
- Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
| | - L Lee Dupuis
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
- Department of Pharmacy, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Lillian Sung
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada.
- Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada.
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29
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Longobardi Y, Parrilla C, Di Cintio G, De Corso E, Marenda ME, Mari G, Paludetti G, D’Alatri L, Passali GC. Olfactory perception rehabilitation after total laryngectomy (OPRAT): proposal of a new protocol based on training of sensory perception skills. Eur Arch Otorhinolaryngol 2020; 277:2095-2105. [DOI: 10.1007/s00405-020-05918-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
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30
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Nikoloudi M, Lymvaios I, Zygogianni A, Parpa E, Strikou DA, Tsilika E, Kouloulias V, Mystakidou K. Quality of Life, Anxiety, and Depression in the Head-and-Neck Cancer Patients, Undergoing Intensity-Modulated Radiotherapy Treatment. Indian J Palliat Care 2020; 26:54-59. [PMID: 32132785 PMCID: PMC7017687 DOI: 10.4103/ijpc.ijpc_168_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 11/02/2019] [Indexed: 12/24/2022] Open
Abstract
Aims: The aim of this study is to investigate and compare distress and quality-of-life parameters among head-and-neck cancer patients who underwent intensity-modulated radiotherapy (IMRT). Subjects and Methods: The patients' sample consists of 55 individuals under IMRT treatment. Three questionnaires (Quality of Life Questionnaire [QLQ]-C30 and QLQ-H and N35) of the European Organization for the Research and Treatment of Cancer and the Greek Hospital Anxiety and Depression Scales were used. Results: Functioning and symptoms scales measured a week before the scheduled treatment worsen significantly until the end of the treatment and at the 3-month follow-up, tend to revert to their pretreatment values. Conclusions: Our results showed that all parameters (functioning scales, symptoms scales, and G-HAD subscales) worsen from the start to the end treatment and tend to revert to their pretreatment values after a 3-month period.
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Affiliation(s)
- Maria Nikoloudi
- Department of Radiology, Pain Relief and Palliative Care Unit, School of Medicine, Areteion Hospital, National and Kapodistrian University of Athens, Corinthia, Greece
| | - Ioannis Lymvaios
- Unit of Thalassemia, General Hospital of Corinthia, Corinthia, Greece
| | - Anna Zygogianni
- Department of Radiology, School of Medicine, Areteion Hospital, National and Kapodistrian University of Athens, Greece
| | - Efi Parpa
- Department of Radiology, Pain Relief and Palliative Care Unit, School of Medicine, Areteion Hospital, National and Kapodistrian University of Athens, Corinthia, Greece
| | - Dimitra-Aspasia Strikou
- Department of Radiology, Radiotherapy Unit, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Greece
| | - Eleni Tsilika
- Department of Radiology, Pain Relief and Palliative Care Unit, School of Medicine, Areteion Hospital, National and Kapodistrian University of Athens, Corinthia, Greece
| | - Vassilios Kouloulias
- Department of Radiology, Radiotherapy Unit, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Greece
| | - Kyriaki Mystakidou
- Department of Radiology, Pain Relief and Palliative Care Unit, School of Medicine, Areteion Hospital, National and Kapodistrian University of Athens, Corinthia, Greece
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31
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Kale YS, Vibhute N, Belgaumi U, Kadashetti V, Bommanavar S, Kamate W. Effect of using tobacco on taste perception. J Family Med Prim Care 2019; 8:2699-2702. [PMID: 31548959 PMCID: PMC6753787 DOI: 10.4103/jfmpc.jfmpc_457_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 06/19/2019] [Accepted: 07/12/2019] [Indexed: 12/28/2022] Open
Abstract
Background: Impaired taste perception has impact on quality of life. Tobacco is a perilous factor that contributes to an impaired taste. Objective: To evaluate and compare taste perception among tobacco chewers and nonchewers. Materials and Methods: Sixty subjects (30 tobacco chewers + 30 nonchewers as controls) were enrolled in the study for evaluating taste perception. Taste identification time using four aqueous solutions of basic tastes – sweet, salty, sour, and bitter – was recorded (in seconds) and compared between tobacco chewers and controls. The data were analyzed using Student's t-test and analysis of variance using SPSS 20 version software. Results: A statistically significant increase in taste identification time for salty taste in tobacco chewers (12.32 s) was noted compared with nonchewers (10.21 s) (P = 0.03). The average taste identification time was higher for tobacco chewers than nonchewers for sweet and salty taste. However, the average taste identification time was lower for tobacco chewers than nonchewers for sour and bitter taste. In nonchewers, the average taste identification time was 13.01, 10.21, 8.43, and 7.56 s for sweet, salty, bitter, and sour taste, respectively. In tobacco chewers, the average taste identification time was 15.16, 12.32, 7.75, and 7.04 s for sweet, salty, bitter, and sour taste, respectively. Conclusion: The results of the study demonstrated noticeable decrease in taste perception to salty taste among tobacco chewers when compared with tobacco nonchewers. There is a remarkable difference in taste perception to basic tastes among tobacco chewers and controls.
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Affiliation(s)
- Yugandhara S Kale
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences "Deemed to be University", Malakapur, Karad, Satara, Maharashtra, India
| | - Nupura Vibhute
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences "Deemed to be University", Malakapur, Karad, Satara, Maharashtra, India
| | - Uzma Belgaumi
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences "Deemed to be University", Malakapur, Karad, Satara, Maharashtra, India
| | - Vidya Kadashetti
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences "Deemed to be University", Malakapur, Karad, Satara, Maharashtra, India
| | - Sushma Bommanavar
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences "Deemed to be University", Malakapur, Karad, Satara, Maharashtra, India
| | - Wasim Kamate
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences "Deemed to be University", Malakapur, Karad, Satara, Maharashtra, India
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Gevorkov AR, Boyko AV, Volkova EE, Shashkov SV. Prevalence, clinical significance and possible correction of taste and smell abnormalities in patients with oncological diseases. HEAD AND NECK TUMORS (HNT) 2019. [DOI: 10.17650/2222-1468-2019-9-2-53-65] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Affiliation(s)
- A. R. Gevorkov
- P.A. Hertzen Moscow Oncology Research Institute — branch of the National Medical Research Radiology Center of the Ministry of Health of Russia
| | - A. V. Boyko
- P.A. Hertzen Moscow Oncology Research Institute — branch of the National Medical Research Radiology Center of the Ministry of Health of Russia
| | | | - S. V. Shashkov
- P.A. Hertzen Moscow Oncology Research Institute — branch of the National Medical Research Radiology Center of the Ministry of Health of Russia
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Changes in taste among pediatric patients with cancer and hematopoietic stem cell transplantation recipients. Qual Life Res 2019; 28:2941-2949. [PMID: 31273626 DOI: 10.1007/s11136-019-02242-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2019] [Indexed: 01/28/2023]
Abstract
PURPOSE Changes in taste is a common bothersome symptom in children receiving cancer treatments. However, little is known about how pediatric cancer patients experience this symptom. The objective was to describe how children receiving cancer treatments experience taste alterations and the approaches they use to address the issue. METHODS In this qualitative study, we included English-speaking children 4-18 years of age with cancer or hematopoietic stem cell transplantation recipients who were actively receiving cancer treatment or who had completed therapy. Using a semi-structured questionnaire, we asked questions about the experience of altered taste sensation. We asked about its characteristics, impacts and identified coping strategies. RESULTS We included 50 children. Children experienced changes in taste in a heterogeneous fashion although commonly described food as tasting "different", "not right" or "funny". While change in food preferences due to taste alterations was common, specific choices varied. Many found changes started with treatment initiation or mid-way through treatment, and some found that symptoms persisted up to 9 months following treatment completion. Actions taken to address taste changes were sucking on candy, brushing teeth and modifying food choices. CONCLUSIONS The experience of changes in taste was common yet highly variable in its presentation and resultant changes in food preferences. Taste changes did not always resolve soon after treatment completion. Future research should identify ways to manage this symptom in pediatric cancer patients.
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Barbosa da Silva JL, Doty RL, Miyazaki JVMK, Borges R, Pinna FDR, Voegels RL, Fornazieri MA. Gustatory disturbances occur in patients with head and neck cancer who undergo radiotherapy not directed to the oral cavity. Oral Oncol 2019; 95:115-119. [PMID: 31345378 DOI: 10.1016/j.oraloncology.2019.06.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 05/14/2019] [Accepted: 06/07/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Even the most modern radiation techniques still result in some degree of toxicity to adjacent normal tissues. Consequently, the radiotherapy treatment in head and neck neoplasms potentially leads to gustatory dysfunction even in cases when the treatment area is outside or adjacent to the oral cavity. In this study we quantitatively and qualitatively assessed gustatory function in patients with head and neck cancers who underwent radiotherapy inside and outside of the oral cavity. METHODS Fifty-six patients with head and neck cancer responded to a specific questionnaire and had their gustatory function tested before, immediately after, and at 3 and 6 months following radiotherapy treatment. The irradiation field did not include the oral cavity in 29 patients and included it in 27 patients. RESULTS All patients suffered a severe loss of taste immediately after radiotherapy. The identification of sweet and bitter tastes decreased in both groups, but the sour decrement was exclusive to those who had the oral cavity irradiated. Fourteen percent of patients complained of qualitative changes of taste, namely taste distortions. No impact of xerostomia on the taste measures was apparent. CONCLUSION We found that patients with head and neck neoplasms submitted to radiotherapy have disturbed taste even when irradiation does not include the oral cavity. This deficit is worse immediately after the end of radiotherapy. Our findings do not support the hypothesis that decreased salivary flow is the major cause for radiation-induced changes in taste function.
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Affiliation(s)
| | - Richard L Doty
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | | | - Ricardo Borges
- Division of Otorhinolaryngology, University of Sao Paulo, Brazil
| | | | | | - Marco Aurélio Fornazieri
- Department of Surgery, Londrina State University and Pontifical Catholic University of Parana, Brazil.
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Fjaeldstad A, Niklassen AS, Fernandes HM. Re-Test Reliability of Gustatory Testing and Introduction of the Sensitive Taste-Drop-Test. Chem Senses 2019. [PMID: 29538619 DOI: 10.1093/chemse/bjy019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The sense of taste holds a key integrate role in assessing the flavor of food before swallowing is initiated. If the expectations for taste are not met, palatability and pleasure of the food can decrease. In patients suffering from taste disorders, this may impair appetite and nutritional state. Testing gustatory function can be important for diagnostics and assessment of treatment effects. However, the gustatory tests applied are required to be both sensitive and reliable. In this study, we investigate the re-test validity of popular Taste Strips gustatory test for gustatory screening. Furthermore, we introduce a new sensitive Taste-Drop-Test, which was found to be superior for detecting a more accurate measure of tastant sensitivity.
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Affiliation(s)
- Alexander Fjaeldstad
- Flavour Institute, Aarhus University, Noerrebrogade, Aarhus, Denmark.,Flavour Clinic, ENT Department, Holstebro Regional Hospital, Laegaardsvej, Holstebro, Denmark.,Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.,Center of Functionally Integrative Neuroscience, Aarhus University, Noerrebrogade, Aarhus, Denmark
| | | | - Henrique M Fernandes
- Flavour Institute, Aarhus University, Noerrebrogade, Aarhus, Denmark.,Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.,Center of Functionally Integrative Neuroscience, Aarhus University, Noerrebrogade, Aarhus, Denmark.,Center for Music in the Brain, Aarhus University & The Royal Academy of Music Aarhus/Aalborg, Nørrebrogade, Aarhus C, Denmark
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Deshpande TS, Blanchard P, Wang L, Foote RL, Zhang X, Frank SJ. Radiation-Related Alterations of Taste Function in Patients With Head and Neck Cancer: a Systematic Review. Curr Treat Options Oncol 2018; 19:72. [PMID: 30411162 PMCID: PMC6244914 DOI: 10.1007/s11864-018-0580-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OPINION STATEMENT Taste sensation is vital for a healthy body as it influences our food intake, acts as a defense mechanism and elicits pleasure. Majority of the head and neck cancer (HNC) patients undergoing radiotherapy suffer from altered taste function and often complain of inability to taste their food, reduced food intake, and weakness. However, there are not many studies conducted to assess this commonly reported side effect. Furthermore, clinical research on radiotherapy-induced taste alterations has proven to be difficult, considering a lack of reliable and validated study tools for assessing objective and subjective outcomes. Developing standardized tools for assessment of taste function and conducting prospective studies in larger population of HNC is the need of the hour. Taste sensation being critically important for sustenance, we need to focus on ways to preserve it. The physical properties of proton particle enable localization of the radiation dose precisely to the tumor and minimizing the exposure of the adjacent healthy tissues. By using Intensity-Modulated Proton Therapy in HNC patients, we anticipate preserving the taste sensation by reducing the dose of radiation to the taste buds.
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Affiliation(s)
- Tanaya S Deshpande
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1840 Old Spanish Trail, Box 1150, Houston, TX, 77054, USA
| | - Pierre Blanchard
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1840 Old Spanish Trail, Box 1150, Houston, TX, 77054, USA
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - Li Wang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1052, Houston, TX, 77030, USA
| | - Robert L Foote
- Department of Radiation Oncology, The Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Xiaodong Zhang
- Department of Radiation Physics, UT MD Anderson Cancer Center, 1840 Old Spanish Trail, Houston, TX, 77054, USA
| | - Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1840 Old Spanish Trail, Box 1150, Houston, TX, 77054, USA.
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37
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Taste changes in children with cancer and hematopoietic stem cell transplant recipients. Support Care Cancer 2018; 27:2247-2254. [DOI: 10.1007/s00520-018-4509-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 10/09/2018] [Indexed: 10/28/2022]
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38
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Jin S, Lu Q, Jin S, Zhang L, Cui H, Li H. Relationship between subjective taste alteration and weight loss in head and neck cancer patients treated with radiotherapy: A longitudinal study. Eur J Oncol Nurs 2018; 37:43-50. [PMID: 30473050 DOI: 10.1016/j.ejon.2018.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To conduct a dynamic and comprehensive evaluation of subjective taste alteration (STA)and identify the association between STA and weight loss in patients with head and neck cancer (HNC) who were treated with radiotherapy. METHODS STA and weight of 114 patients were recorded at baseline, mid-treatment, post-treatment, and one to two months after radiotherapy (follow-up). Generalized estimating equations (GEE) were used to conduct repeated measures analyses of STA and weight loss at four time-points and assess the relationship between them. RESULTS The prevalence of STA was 13.2% (baseline), 83.3% (mid-treatment), 92.1% (post-treatment), and 77.9% (follow-up), respectively; the prevalence of ≥10% weight loss increased from 1.8% (mid-treatment) to 44.2% (follow-up). The severity of STA was increasingly poor with radiation therapy and did not return to the baseline level at the follow-up. Meanwhile, the weight of patients did not increase at the follow-up. Among the four subscales of STA (decline in basic taste, general taste alterations, phantogeusia and parageusia, and discomfort), only the discomfort score (β = -2.988; p = 0.005; 95%confidence interval: -5.084-0.891) had a significant effect on weight loss. CONCLUSIONS The main finding of this study was that STA, particularly the discomfort symptom associated with dietary intake, as a common and persistent symptom among HNC patients during and after radiotherapy, might promote weight loss in patients, which should be afforded greater attention from medical staff.
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Affiliation(s)
- Shuai Jin
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, 100191, Beijing, China
| | - Qian Lu
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, 100191, Beijing, China.
| | - Sanli Jin
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, 100191, Beijing, China
| | - Lichuan Zhang
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, 100191, Beijing, China
| | - Hangjing Cui
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, 100191, Beijing, China
| | - Hongmei Li
- ShanXi Hospital of Integrated Traditional and Western Medicine, 030013, Taiyuan, China
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Campagna S, Gonella S, Sperlinga R, Giuliano P, Marchese R, Pedersini R, Berchialla P, Dimonte V. Prevalence, Severity, and Self-Reported Characteristics of Taste Alterations in Patients Receiving Chemotherapy. Oncol Nurs Forum 2018; 45:342-353. [DOI: 10.1188/18.onf.342-353] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Roughly 436,000 survivors are living with a history of head and neck cancer (HNC), accounting for approximately 3% of all cancer survivors in the United States [1, 2]. With advances in treatment, long-term survival is increasingly common in HNC populations. Despite increasing awareness of survivorship issues, many challenges remain. These include lack of knowledge on late and long-term effects of treatment, and poor integration of survivorship care guidelines into oncology practice. Survivorship care plans (SCPs) are increasingly important for HNC survivors to improve quality of long-term survival. Quality survivorship care should focus on management of late and long-term effects of treatment, surveillance for cancer recurrence and second primaries, promotion of healthy lifestyle, and care coordination between providers. This chapter will describe common quality of life (QOL) issues in HNC survivorship, and review the current survivorship care guidelines in HNC.
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Affiliation(s)
- Denice Economou
- Division of Nursing Research and Education, Department of Populations Sciences, City of Hope, Duarte, CA, USA.
| | - Virginia Sun
- Division of Nursing Research and Education, Department of Populations Sciences, City of Hope, Duarte, CA, USA
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41
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Spotten L, Corish C, Lorton C, Ui Dhuibhir P, O’Donoghue N, O’Connor B, Walsh T. Subjective and objective taste and smell changes in cancer. Ann Oncol 2017; 28:969-984. [DOI: 10.1093/annonc/mdx018] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Follow-up and Survivorship in Head and Neck Cancer. Clin Oncol (R Coll Radiol) 2016; 28:451-8. [DOI: 10.1016/j.clon.2016.03.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 02/23/2016] [Accepted: 03/03/2016] [Indexed: 12/14/2022]
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Cohen EEW, LaMonte SJ, Erb NL, Beckman KL, Sadeghi N, Hutcheson KA, Stubblefield MD, Abbott DM, Fisher PS, Stein KD, Lyman GH, Pratt-Chapman ML. American Cancer Society Head and Neck Cancer Survivorship Care Guideline. CA Cancer J Clin 2016; 66:203-39. [PMID: 27002678 DOI: 10.3322/caac.21343] [Citation(s) in RCA: 383] [Impact Index Per Article: 47.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. A systematic review of the literature was conducted using PubMed through April 2015, and a multidisciplinary expert workgroup with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech-language pathology, physical medicine and rehabilitation, the patient perspective, and nursing was assembled. While the guideline is based on a systematic review of the current literature, most evidence is not sufficient to warrant a strong recommendation. Therefore, recommendations should be viewed as consensus-based management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment. CA Cancer J Clin 2016;66:203-239. © 2016 American Cancer Society.
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Affiliation(s)
- Ezra E W Cohen
- Medical Oncologist, Moores Cancer Center, University of California at San Diego, La Jolla, CA
| | - Samuel J LaMonte
- Retired Head and Neck Surgeon, Former Associate Professor of Otolaryngology and Head and Neck Surgery, Louisiana State University Health and Science Center, New Orleans, LA
| | - Nicole L Erb
- Program Manager, National Cancer Survivorship Resource Center, American Cancer Society, Atlanta, GA
| | - Kerry L Beckman
- Research Analyst-Survivorship, American Cancer Society, Atlanta, GA
| | - Nader Sadeghi
- Professor of Surgery, Division of Otolaryngology-Head and Neck Cancer Surgery, and Director of Head and Neck Surgical Oncology, George Washington University, Washington, DC
| | - Katherine A Hutcheson
- Associate Professor, Department of Head and Neck Surgery, Section of Speech Pathology and Audiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael D Stubblefield
- Medical Director for Cancer Rehabilitation, Kessler Institute for Rehabilitation, West Orange, NJ
| | - Dennis M Abbott
- Chief Executive Officer, Dental Oncology Professionals, Garland, TX
| | - Penelope S Fisher
- Clinical Instructor of Otolaryngology and Nurse, Miller School of Medicine, Department of Otolaryngology, Division of Head and Neck Surgery, University of Miami, Miami, FL
| | - Kevin D Stein
- Vice President, Behavioral Research, and Director, Behavioral Research Center, American Cancer Society, Atlanta, GA
| | - Gary H Lyman
- Co-Director, Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, and Professor of Medicine, University of Washington School of Medicine, Seattle, WA
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Okada N, Hanafusa T, Abe S, Sato C, Nakamura T, Teraoka K, Abe M, Kawazoe K, Ishizawa K. Evaluation of the risk factors associated with high-dose chemotherapy-induced dysgeusia in patients undergoing autologous hematopoietic stem cell transplantation: possible usefulness of cryotherapy in dysgeusia prevention. Support Care Cancer 2016; 24:3979-85. [PMID: 27129837 DOI: 10.1007/s00520-016-3244-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/24/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Dysgeusia is one of the sporadic adverse effects induced by chemotherapy, but it remains poorly understood. The aim of this study was to retrospectively identify the risk factors related with dysgeusia in patients undergoing autologous hematopoietic stem cell transplantation (AHSCT). METHODS Forty-eight patients with myeloma or lymphoma undergoing AHSCT were enrolled in this study. Data regarding dysgeusia and symptoms were collected by interviews conducted by medical workers. Patient characteristics and unfavorable effects induced by dysgeusia were obtained from medical records and analyzed. Logistic regression analysis was performed to identify the risk factors related with dysgeusia. RESULTS Of the 48 patients, 20 (42 %) had dysgeusia after AHSCT. The total period of parenteral nutrition (TPN) administration and period of decreased oral intake in the dysgeusia group were statistically longer than those in the non-dysgeusia group. Multivariate analyses revealed that oral mucositis (odds ratio: 30.3; p < 0.01) and the type of chemotherapy prior to AHSCT (odds ratio: 6.56; p < 0.05) were independent risk factors, while oral cryotherapy was the independent suppressive factor of dysgeusia (odds ratio: 0.14; p < 0.05). CONCLUSION Our study showed that dysgeusia after AHSCT led to the decrease in oral intake and extended the TPN administration period. Moreover, MEAM or LEED chemotherapy and oral mucositis were independent risk factors for dysgeusia in patients undergoing AHSCT, while oral cryotherapy was an independent suppressive factor for dysgeusia. Therefore, oral cryotherapy should be implemented into the regimen of supportive care management in patients undergoing AHSCT.
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Affiliation(s)
- Naoto Okada
- Department of Clinical Pharmacy Practice Pedagogy Institute of Biomedical Sciences, Tokushima University Graduate School, 1-78-1 Shomachi, Tokushima, 770-8505, Japan. .,Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima, 770-8503, Japan.
| | - Takeshi Hanafusa
- Faculty of Pharmaceutical Sciences, University of Tokushima, Shomachi-1, Tokushima, 770-8505, Japan
| | - Shinji Abe
- Department of Clinical Pharmacy Practice Pedagogy Institute of Biomedical Sciences, Tokushima University Graduate School, 1-78-1 Shomachi, Tokushima, 770-8505, Japan
| | - Chiemi Sato
- Department of Clinical Pharmacy Practice Pedagogy Institute of Biomedical Sciences, Tokushima University Graduate School, 1-78-1 Shomachi, Tokushima, 770-8505, Japan
| | - Toshimi Nakamura
- Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima, 770-8503, Japan
| | - Kazuhiko Teraoka
- Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima, 770-8503, Japan
| | - Masahiro Abe
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-8-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Kazuyoshi Kawazoe
- Department of Clinical Pharmacy Practice Pedagogy Institute of Biomedical Sciences, Tokushima University Graduate School, 1-78-1 Shomachi, Tokushima, 770-8505, Japan
| | - Keisuke Ishizawa
- Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima, 770-8503, Japan.,Department of Clinical Pharmacy, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-8-15 Kuramoto, Tokushima, 770-8503, Japan
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Bressan V, Stevanin S, Bianchi M, Aleo G, Bagnasco A, Sasso L. The effects of swallowing disorders, dysgeusia, oral mucositis and xerostomia on nutritional status, oral intake and weight loss in head and neck cancer patients: A systematic review. Cancer Treat Rev 2016; 45:105-19. [DOI: 10.1016/j.ctrv.2016.03.006] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/07/2016] [Accepted: 03/08/2016] [Indexed: 02/07/2023]
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47
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Subjective taste and smell changes in treatment-naive people with solid tumours. Support Care Cancer 2016; 24:3201-8. [PMID: 26945569 DOI: 10.1007/s00520-016-3133-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/19/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE Taste and smell changes (TSCs) are common in head and neck (H&N) cancer and during and after chemotherapy (CT) and radiotherapy (RT). It is an area that has been under-investigated, particularly in the treatment-naive, but can negatively impact nutritional status. This study examined the prevalence, severity and characteristics of TSCs in people with non-H&N solid tumours, before CT and RT, and their relationship with co-occurring symptoms. METHODS A prospective, observational study was conducted. Forty consecutive pre-treatment cancer patients, referred to radiation oncology outpatients over 6 weeks, were recruited. Data on TSCs, symptoms and nutritional status were obtained using the 'Taste and Smell Survey' and the 'abridged Patient-Generated Subjective Global Assessment' (abPG-SGA). BMI was measured. SPSS® was used for statistical analysis. Two-sided P values <0.05 were considered statistically significant. RESULTS Most patients were newly diagnosed (n = 28; 70 %). Nineteen (48 %) reported TSCs; nine noted a stronger sweet and seven a stronger salt taste. Of these, four reported a stronger and four a weaker smell sensation. Those at nutritional risk reported more TSCs (n = 13/20). TSCs were significantly associated with dry mouth (P < 0.01), early satiety (P < 0.05) and fatigue (P < 0.05). CONCLUSIONS TSCs preceded CT or RT in almost half of treatment-naive patients with solid tumours, notably stronger sweet and salt tastes. Half of the study group were at nutritional risk; the majority of these reported TSCs. TSCs were significantly associated with other symptoms. Future research and clinical guidelines, with a common terminology for assessment, diagnosis and management of cancer TSCs, are needed.
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Structured review of papers reporting specific functions in patients with cancer of the head and neck: 2006 - 2013. Br J Oral Maxillofac Surg 2016; 54:e45-51. [PMID: 26923873 DOI: 10.1016/j.bjoms.2016.02.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 02/09/2016] [Indexed: 11/21/2022]
Abstract
Health-related quality of life (HRQoL) focuses on 4 core domains: physical and psychological function, social interaction, disease, and treatment-related symptoms, and is a key outcome in patients with cancer of the head and neck. We reviewed papers published between 2006 and 2013 that used validated questionnaires to report functional outcome in this group. A total of 572 papers were identified and 118 of them concerned function. Specific outcomes included anxiety, chewing, maxillectomy, mucositis, pain, shoulder function, and trismus. The specific functions most often identified were xerostomia, speech or voice, and swallowing or dysphagia. A considerable body of evidence has now accumulated on HRQoL and functional outomes although the precise role of HRQoL during the planning of treatment remains controversial. Over time, the emphasis of the studies included has tended to move away from the reporting of outcomes in general to more hypothesis-driven and group-specific work.
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Alvarez-Camacho M, Gonella S, Ghosh S, Kubrak C, Scrimger RA, Chu KP, Wismer WV. The impact of taste and smell alterations on quality of life in head and neck cancer patients. Qual Life Res 2015. [PMID: 26589527 DOI: 10.1007/s11136‐015‐1185‐2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
PURPOSE Taste and smell alterations (TSAs) are among the most frequent and troublesome symptoms reported by head and neck cancer (HNC) patients after treatment. Little is known about the relationship between TSAs and quality of life (QoL) among HNC patients. The aim of this study was to determine the effect of TSAs on overall QoL among tube-fed and orally fed HNC patients before treatment, at end of treatment and at 2.5-month follow-up. METHODS Data were collected in a longitudinal study prior to treatment (n = 126), at end of treatment (n = 100) and at 2.5-month follow-up (n = 85). Chemosensory Complaint Score (CCS) and the University of Washington Quality of Life Questionnaire version 3 were used to assess TSAs and QoL, respectively. Generalized estimated equation modeling was used to estimate the effect of CCS on QoL. RESULTS At end of treatment, QoL and CCS had declined for both tube-fed and orally fed patients and thereafter improved, but not to pre-treatment levels. Neither QoL nor CCS mean scores were different between the two groups at any time point. CCS was a significant predictor of overall QoL (β = -1.82, p < 0.0001), social-emotional (β = -1.76, p < 0.0001), physical (β = -1.12, p < 0.0001) and overall functions (β = -1.15, p < 0.0001) at a multivariate level. Taste was reported as an important symptom for both tube-fed and orally fed groups at end of treatment and follow-up. CONCLUSIONS TSAs are an important symptom and an independent predictor of QoL for both tube-fed and orally fed HNC patients. HNC patients need support to manage TSAs, regardless of the method of nutritional intake.
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Affiliation(s)
- M Alvarez-Camacho
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - S Gonella
- Dipartimento di Sanità Pubblica e Medicina di Comunità, Università degli Studi di Verona, Verona, Italy.,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy
| | - S Ghosh
- Division of Medical Oncology, Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - C Kubrak
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, Canada.,Outpatient Department, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - R A Scrimger
- Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - K P Chu
- Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - W V Wismer
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada.
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The impact of taste and smell alterations on quality of life in head and neck cancer patients. Qual Life Res 2015; 25:1495-504. [PMID: 26589527 DOI: 10.1007/s11136-015-1185-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Taste and smell alterations (TSAs) are among the most frequent and troublesome symptoms reported by head and neck cancer (HNC) patients after treatment. Little is known about the relationship between TSAs and quality of life (QoL) among HNC patients. The aim of this study was to determine the effect of TSAs on overall QoL among tube-fed and orally fed HNC patients before treatment, at end of treatment and at 2.5-month follow-up. METHODS Data were collected in a longitudinal study prior to treatment (n = 126), at end of treatment (n = 100) and at 2.5-month follow-up (n = 85). Chemosensory Complaint Score (CCS) and the University of Washington Quality of Life Questionnaire version 3 were used to assess TSAs and QoL, respectively. Generalized estimated equation modeling was used to estimate the effect of CCS on QoL. RESULTS At end of treatment, QoL and CCS had declined for both tube-fed and orally fed patients and thereafter improved, but not to pre-treatment levels. Neither QoL nor CCS mean scores were different between the two groups at any time point. CCS was a significant predictor of overall QoL (β = -1.82, p < 0.0001), social-emotional (β = -1.76, p < 0.0001), physical (β = -1.12, p < 0.0001) and overall functions (β = -1.15, p < 0.0001) at a multivariate level. Taste was reported as an important symptom for both tube-fed and orally fed groups at end of treatment and follow-up. CONCLUSIONS TSAs are an important symptom and an independent predictor of QoL for both tube-fed and orally fed HNC patients. HNC patients need support to manage TSAs, regardless of the method of nutritional intake.
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