title: Predictors of Dysgeusia in Patients With Oropharyngeal Cancer Treated With Chemotherapy and Intensity Modulated Radiation Therapy.
abstract: Dysgeusia is a significant factor reducing quality of life and worsening dysphagia in patients receiving chemoradiation therapy for head and neck cancer. The factors affecting dysgeusia severity are uncertain. We investigated the effects on patient-reported dysgeusia of doses to the oral cavity, salivary output (required to dissolve food particles), and patient-reported xerostomia.
  
  
  
  Seventy-three patients with stage III to IV oropharyngeal cancer (OPC) (N=73) receiving definitive intensity modulated radiation therapy concurrently with chemotherapy participated in a prospective, longitudinal study of quality of life (QOL), including assessment of patient-reported gustatory function by taste-related questions from the Head and Neck QOL instrument (HNQOL) and the University of Washington Head and Neck-related QOL instrument (UWQOL), before therapy and periodically after treatment. At these intervals, patients also completed a validated xerostomia-specific questionnaire (XQ) and underwent unstimulated and stimulated major salivary gland flow rate measurements.
  
  
  
  At 1, 3, 6, and 12 months after treatment, dysgeusia improved over time: severe dysgeusia was reported by 50%, 40%, 22%, and 23% of patients, respectively. Significant associations were found between patient-reported severe dysgeusia and radiation dose to the oral cavity (P=.005) and tongue (P=.019); normal tissue complication probability for severe dysgeusia at 3 months showed mean oral cavity D50 doses 53 Gy and 57 Gy in the HNQOL and WUQOL questionnaires, respectively, with curve slope (m) of 0.41. Measured salivary output was not statistically significantly correlated with severe taste dysfunction, whereas patient-reported XQ summary scores and xerostomia while eating scores were correlated with severe dysgeusia in the UWQOL tool (P=.04).
  
  
  
  Taste impairment is significantly correlated with mean radiation dose to the oral cavity. Patient-reported xerostomia, but not salivary output, was correlated with severe dysgeusia in 1 of the 2 QOL questionnaires. Reduction in oral cavity doses is likely to improve dysgeusia.
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Eli
authors.initials: E
authors.lastname: Sapir
authors.affiliation: Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
authors.forename: Yebin
authors.initials: Y
authors.lastname: Tao
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Felix
authors.initials: F
authors.lastname: Feng
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Stuart
authors.initials: S
authors.lastname: Samuels
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Issam
authors.initials: I
authors.lastname: El Naqa
authors.affiliation: School of Dentistry, University of Michigan, Ann Arbor, Michigan.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Murdoch-Kinch
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Mary
authors.initials: M
authors.lastname: Feng
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
authors.forename: Matthew
authors.initials: M
authors.lastname: Schipper
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan. Electronic address: eisbruch@umich.edu.
authors.forename: Avraham
authors.initials: A
authors.lastname: Eisbruch
mesh_terms: D000328:Adult; D000368:Aged; D015984:Causality; D059248:Chemoradiotherapy / Q000523:psychology / Q000706:statistics & numerical data*; D015897:Comorbidity; D004408:Dysgeusia / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000706:statistics & numerical data; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000523:psychology / Q000706:statistics & numerical data*; D012307:Risk Factors; D016896:Treatment Outcome; D014987:Xerostomia / Q000453:epidemiology* / Q000523:psychology