Olfaction in chemotherapy for head and neck malignancies

Area of Science:

• Oncology
• Neuroscience
• Sensory Science

Background:

• Systemic chemotherapy can cause various side effects, including sensory dysfunction.
• The impact of chemotherapeutic agents on olfaction is not well understood.
• Head and neck cancers often present with or lead to malnutrition, potentially exacerbated by sensory changes.

Purpose of the Study:

• To investigate the effects of chemotherapy on olfactory function in patients with advanced head and neck squamous cell carcinomas.
• To provide data on changes in the sense of smell during chemotherapy treatment.

Main Methods:

• Prospective, controlled cohort study involving 33 patients undergoing up to three cycles of chemotherapy (cisplatin, 5-fluorouracil, docetaxel).
• Olfaction was assessed using the Sniffin' Sticks test (TDI score) before and after each chemotherapy cycle, with follow-up.
• Patient data included age, sex, smoking status, and cancer location (primarily oropharynx).

Main Results:

• A significant decrease in olfactory function (TDI score) was observed during the second chemotherapy cycle.
• Older age (>55 years) negatively influenced olfactory scores in the first two cycles.
• Smokers showed a tendency towards decreased TDI scores; olfactory function generally recovered between cycles.

Conclusions:

• Chemotherapy regimens including cisplatin, 5-fluorouracil, and docetaxel have a minor but significant impact on olfaction.
• This olfactory dysfunction is more pronounced in elderly patients and smokers, potentially worsening malnutrition.
• No cumulative effect on olfaction was detected, with recovery observed within three weeks post-cycle.