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Abnormal visual and olfactory sensations during radiation therapy: a prospective study.

Yiling Mai1, Celina Vogel2,3, Julia Thiele3,4

  • 1Smell and Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany. Yling.Mai@uniklinikum-dresden.de.

Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft ... [Et Al]
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Summary

Phantosmias and phosphenes are common during radiation therapy (RT). Factors like younger age, brain radiation, and proton RT influence these sensations, suggesting central neural mechanisms.

Keywords:
PhantosmiaPhosphenePhotonProtonRadiation therapy

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Area of Science:

  • Neurology
  • Oncology
  • Ophthalmology
  • Otolaryngology

Background:

  • Patients undergoing radiation therapy (RT) may experience sensory phenomena like phosphenes (visual disturbances) and phantosmias (olfactory hallucinations).
  • The characteristics and influencing factors of these sensations during RT are not well understood, necessitating further investigation.

Purpose of the Study:

  • To investigate the detailed characteristics of phantosmias and phosphenes experienced by patients during RT.
  • To identify factors influencing the occurrence, intensity, and hedonic (pleasantness/unpleasantness) ratings of these abnormal sensations.

Main Methods:

  • A prospective study included 106 patients undergoing RT in brain, ENT, or other body regions.
  • Data collected included medical history, treatment parameters, baseline olfactory function (Sniffin' Stick Test), and weekly self-reported phantosmia and phosphene occurrences.
  • Patients underwent RT for approximately 43 ± 5 days.

Main Results:

  • 37% of patients reported phantosmias, 51% reported phosphenes, and 29% experienced both.
  • Phosphenes appeared as flashes of blue, white, or purple light; phantosmias were perceived as chemical-like, metallic, or burnt smells.
  • Younger age, brain radiation, absence of taste problems, and proton RT were associated with increased occurrence. History of chemical exposure reduced phantosmia intensity and unpleasantness.

Conclusions:

  • Phantosmias and phosphenes are common occurrences during RT, influenced by treatment parameters and individual patient factors.
  • These sensations may arise from central neural mechanisms rather than solely peripheral ones.
  • The findings suggest that RT can activate neural areas beyond traditional olfactory and visual pathways.