A real world study of dysgeusia-related factors in head and neck cancer patients undergoing radiotherapy.

Abstract

e18146 Background: Dysgeusia, defined as altered taste perception, is a common but often overlooked side effect in head and neck cancer (HNC) treatment. It can significantly disrupt eating habits and compromise nutritional status. This study aimed to evaluate the incidence of dysgeusia in HNC patients undergoing radiotherapy at Santa Izabel Hospital in Brazil and to explore associated factors, including type of radiotherapy (adjuvant or standalone, with or without chemotherapy), tumor location, behavioral risk factors, socioeconomic status, and its impact on weight progression during treatment. Methods: This observational cross-sectional study analyzed medical records of 57 HNC patients who underwent radiotherapy and completed treatment between August 2022 and August 2024. Patients received daily evaluations by an oral medicine specialist following radiotherapy sessions. Sociodemographic and clinical data, including dysgeusia incidence and severity (Common Terminology Criteria for Adverse Events) and baseline nutritional status, were collected from the start to the end of treatment. Results: The majority of patients were male (70.18%) and over 45 years old (87.72%), with oropharyngeal cancer being the most prevalent type (42.11%). Of the patients, 43.8% underwent concurrent chemoradiotherapy with cisplatin, 54.3% received a total dose of 70 Gy, and 59.6% completed treatment in 33–35 sessions. Dysgeusia affected 93% of patients, with the highest occurrence reported around the 8th session of radiotherapy. Multivariate analysis revealed significant associations between dysgeusia and education level (p = 0.049), weight loss (p = 0.03), accumulated radiotherapy dose (p = 0.04), and adjuvant chemotherapy (p = 0.007). Dysgeusia was notably more severe in patients treated with concurrent cisplatin-based chemoradiotherapy. In contrast, no significant associations were found with age, comorbidities, risk factors, tumor stage, planned target volume, or mucositis grading. Conclusions: Chemoradiotherapy and cumulative radiotherapy dose were strongly associated with dysgeusia, emphasizing the role of therapeutic factors as key contributors. Dysgeusia was significantly associated with weight loss, highlighting its profound impact on food intake, nutritional status, and overall treatment outcomes. Additionally, a significant correlation of dysgeusia and educational level was identified. This finding suggests a potential link to socioeconomic status and highlights the need for further exploration into how demographic factors influence the perception and reporting of treatment-related toxicities. Addressing dysgeusia is crucial to improving patient care, as it directly affects treatment courses and overall recovery in HNC patients undergoing radiotherapy.