Development and Validation of Dysgeusia Grading Scale for Patients with Head and Neck Cancers Treated with Intensity-Modulated Radiation Therapy: A Research Protocol

Head and neck cancer patients present with dysgeusia despite the advent of modern radiotherapy techniques. However, there is currently no tool that can be used to evaluate taste alteration in patients undergoing radiotherapy. The objective of this project is to develop and validate a grading scale that is used to assess taste alteration in head and neck cancer patients treated with Intensity- Modulated Radiotherapy. The study will be conducted in three phases. First step is conceptualization and generation of the Dysgeusia Grading Scale. Second is the preliminary item evaluation phase wherein content validity will be determined through an expert panel review. Last is the scale refinement, pilot-, and field- testing phase to assess the validity, reliability, and sensitivity of the scale.

Validation of the Dutch version of the Chemotherpy-induced Taste Alteration Scale (CiTAS)

Purpose: Taste and smell alterations are known side-effects of an oncological treatment with chemotherapy and can cause reduced food intake and lead to malnutrition and cachexia. ESPEN guidelines state that organizations should foresee a protocol to identify patients at nutritional risk and that screening should be available for all patients. The Chemotherapy-induced Taste alteration Scale (CiTAS) is described as a self -reported scale with a high reliability and validity. The aim of this study is to make a back translation and validation of the Chemotherapy-Induced Taste Alteration Scale in Dutch.Methods: The evaluation instrument was constructed in a three-phased project. First, the Japanese version was backtranslated to Dutch and piloted in a cognitive interview. In a second phase, a Delphi procedure was followed. Context validity and Cronbach’s alpha were calculated. In a third phase comfirmatory analysis was tested.Results and conclusion: The overall Cronbach’s alpha was 0.89. The convergent and discriminant validity show us that the items that should be related indeed are, like the items in the construct and that items that shouldn’t, are not, as between the constructs. The scale was successfully backward translated and validated in Dutch and is ready to be used to screen Dutch speaking cancer patients with chemotherapy as a treatment for their cancer diagnosis. This version of CiTAS can be implemented in the Flemish speaking part of Belgium and in the Netherlands.

Tongue ulcer in a patient with COVID-19: a case presentation

Background The emergence of COVID-19 has devastated many parts of the world. From asymptomatic to symptomatic, the virus causes a wide spectrum of presentations. COVID-19 patients may present with oral manifestations. In Afghanistan, where COVID-19 has severely strained the health care system, much of the population lacks proper oral hygiene. This makes the oral cavity a perfect site for SARS-CoV-2 to manifest clinical signs. Case presentation A 62-year-old male was evaluated in the Dentistry Teaching Clinic of Kabul University of Medical Sciences for a painful erosive lesion on dorsal surface of his tongue. He also complained of fever, cough, and taste alteration. He was referred to Afghan Japan Hospital for COVID-19 testing and tested positive. He was followed on for the treatment of SARS-CoV2. After 2 weeks, the patient tested negative and returned to the dentistry clinic for follow-up. Although there were no other signs of COVID-19, the painful erosive lesion on his tongue persisted. Oral evaluation were performed and the patient was advised to practice good hygiene. After 10 days, we observed an asymptomatic geographic tongue without fever and myalgias and the lesion of dorsal surface of tongue improved from severe condition to moderate. Conclusion In conclusion, patients with suspected or confirmed SARS-CoV-2 should be screened for symptoms and physical findings in the oral mucosa To prevent such an outcome, awareness programs need to be implemented for the diagnosis and management of clinical symptoms among patients.

Taste Sensitivity of Elderly People Is Associated with Quality of Life and Inadequate Dietary Intake

Aging has been implicated in the alteration of taste acuity. Diet can affect taste sensitivity. We aimed to investigate the types of tastes altered in elderly Korean people and factors associated with taste alteration in relation to dietary intake and other factors. Elderly participants (≥65 years) and young adults were assessed to determine their recognition thresholds (RT) for sweet, salty, bitter, sour, and umami tastes. Elderly participants were further surveyed for dietary intake and non-nutritional factors. Five taste RTs were correlated with age, but only four taste RTs, except sweetness, differed between the elderly participants and young adults. Inadequate intake of iron, thiamin, folic acid, zinc, and phosphorus among the elderly participants was related to elevated taste RT levels, except for bitter taste. In both correlation and regression analyses, only salty and sour RTs were associated with energy, iron, thiamin, fiber, vitamin C, and riboflavin levels in the elderly participants. The elderly participants’ taste RTs exhibited strong associations with quality of life (QOL) but showed partial relationships with physical activity, number of medicine intakes, social gatherings, and education. Taste sensitivity may decrease with age, which is further influenced by insufficient dietary intake, especially iron and thiamin, and QOL.

LiCl Promotes Recovery of Radiation-Induced Oral Mucositis and Dysgeusia

Oral mucositis and taste dysfunction are frequently complained by patients with head and neck cancer receiving radiotherapy, challenging the clinical outcome of cancer treatment. Recent studies have indicated the protective role of Wnt/β-catenin signaling in radiation-induced oral mucositis (RIOM) and its pivotal role in the development and self-renewal of taste buds. The current study hypothesizes that lithium chloride (LiCl), a potent activator of the Wnt/β-catenin signaling pathway, can promote the postirradiation restoration of oral mucosa integrity and taste function. To validate this hypothesis, we established a RIOM mouse model and evaluated the treatment efficacy of LiCl on oral mucositis and taste dysfunction in comparison with keratinocyte growth factor (KGF), an agent approved by the US Food and Drug Administration for oral mucositis. The results showed that LiCl alleviated the weight loss and tongue ulceration of RIOM mice, promoted proliferation of basal epithelial cells, and inhibited epithelial-mesenchymal transition in tongue mucosa. More important, elevated taste bud renewal and dysgeusia recovery toward sweetness were observed in RIOM mice treated with LiCl as compared to those treated by KGF. Collectively, our data demonstrate that LiCl can mitigate oral mucositis and rescue taste alteration induced by irradiation, and activation of Wnt/β-catenin signaling may represent a promising therapy to improve the quality of life of patients receiving radiotherapy.

Photobiomodulation for Taste Alteration

Photobiomodulation (PBM) therapy employs light at red and near-infrared wavelengths to modulate biological activity. The therapeutic effect of PBM for the treatment or management of several diseases and injuries has gained significant popularity among researchers and clinicians, especially for the management of oral complications of cancer therapy. This entry focuses on the current evidence on the use of PBM for the management of a frequent oral complication due to cancer therapy—taste alteration.

Characteristics of taste alterations in people receiving taxane-based chemotherapy and their association with appetite, weight, and quality of life

Purpose There is limited evidence on the effect of chemotherapy-associated taste alteration. This study aimed to evaluate taste alteration characteristics in patients receiving taxane-based chemotherapy and investigate the association of taste alterations with appetite, weight, quality of life (QOL), and adverse events. Methods This cross-sectional study evaluated 100 patients receiving paclitaxel, docetaxel, or nab-paclitaxel as monotherapy or combination therapy. Taste alterations were evaluated using taste recognition thresholds and severity and symptom scales. Taste recognition thresholds, symptoms, appetite, weight, and adverse events were compared between patients with and without taste alterations, and logistic regression analysis was performed to identify risk factors. Results Of the 100 patients, 59% reported taste alterations. We found significantly elevated taste recognition thresholds (hypogeusia) for sweet, sour, and bitter tastes in the taste alteration group receiving nab-paclitaxel (p = 0.022, 0.020, and 0.039, respectively). The taste alteration group reported general taste alterations, decline in basic taste, and decreased appetite. Neither weight nor QOL was associated with taste alterations. Docetaxel therapy, previous chemotherapy, dry mouth, and peripheral neuropathy were significantly associated with taste alterations. Conclusions Almost 60% of patients receiving taxane-based regimens, especially docetaxel, reported taste alterations. Taste alteration affected the patient’s appetite but did not affect the weight or QOL. Docetaxel therapy, previous chemotherapy, dry mouth, and peripheral neuropathy were independent risk factors for taste alterations.