頭頸部がん患者における味覚に対する放射線治療の効果 - プロスペクティブ研究

The effect of radiotherapy on taste sensation in head and neck cancer patients - a prospective study.

• Michal Asif
• Assaf Moore
• Noam Yarom
• Aron Popovtzer

抄録

背景:

BACKGROUND: One of the main side effects of head and neck (H&N) radiation therapy (RT) is alteration in taste sensation. It causes significant morbidity and has a major effect on quality of life (QoL). The aim of this study was to prospectively define the effect of RT on taste sensation (general, and four basic tastes) and correlate these findings with changes in saliva secretion and QoL questionnaires.

方法:

METHODS: Patients with H&N cancer treated with RT, in which the oral cavity was expected to receive a mean dose of 30 Gray (Gy). Patients were evaluated by Whole-Saliva Sialometry, validated Taste Strips and European Organization for Research and Treatment of Cancer H&N QoL questionnaires prior to RT (T0), mid-point of radiotherapy dose (T1), at the end of radiotherapy (T2) and 1 (T3), 3 (T4) and 12 months (T5) after completion of treatment course.

結果:

28人の患者を募集し、21人の患者が試験手続きを完了し、解析を行った。年齢中央値は66歳（範囲18～90歳）であった。最も一般的な腫瘍部位は口腔であった。高線量体積に対する処方放射線量の中央値は66（範囲60-70）であった。口腔内への平均線量および最大線量の中央値は、それぞれ25.1（範囲14-69）および64.9（範囲30-70）であった。T0とT1とT2の間には、全体的な味覚の有意な減少があった。特定の味覚では、甘味と塩味の感覚に有意な減少があり、苦味では傾向があり、酸味では変化がなかった。T3以降はすべてベースラインに戻った。口腔内への最大または平均投与量と全体的な味覚との間、または舌の異なる部位への投与量と全体的または特定の味覚との間には有意な相関はなかった。T0では、全体的な味覚と全唾液サイアル測定との間に有意な正の相関があり、T1およびT2では強い傾向がみられた。RT中はQoLスコアに有意な低下がみられた。

RESULTS: Twenty-eight patients were recruited, and 21 patients completed study procedures and were analyzed. Median age was 66 years (range 18-90). The most common tumor site was the oral cavity. The median prescribed radiation dose to the high dose volume was 66 (range 60-70). The median mean and max dose to the oral cavity were 25.1 (range 14-69) and 64.9 (range 30-70), respectively. There was a significant decrease in overall taste sensation between T0 and T1 and T2. With specific tastes, there were significant decreases in sensation of sweet and salty, a trend with bitter and no change with sour. All returned to baseline at T3 and onwards. There was no significant correlation between the max or mean dose to the oral cavity and overall taste sensation or between doses to different areas of the tongue and overall or specific tastes. At T0 there was a significant positive correlation between overall taste sensation and whole-saliva sialometry, and at T1 and T2 there were strong trends. There were significant declines in QoL scores during RT.

結論:

CONCLUSIONS: We found a significant immediate reduction in taste sensation due to RT in H&N cancer patients with taste recovery 1 month after treatment completion. There were strong trends to a correlation with saliva production that requires further exploration.