Taste Function in Oropharyngeal Cancer Treatment: A Prospective Cohort Study

Introduction: Taste disorders (TDs) in head and neck cancer survivors are distressing and are a barrier to food intake. This study’s objective was to calculate TD prevalence before and after treatment for oropharynx cancer over a 9-month follow-up period using subjective and objective taste measures.

Methods: This is a preliminary analysis of an ongoing prospective cohort study. Oropharynx cancer patients and healthy controls were recruited at a tertiary academic hospital from 2021-2023. Patients received definitive chemoradiation (CRT) or surgery ± adjuvant radiation/chemoradiation (aRT/aCRT). Primary outcome was a Clinical Global Impression (CGI) of taste (“My sense of taste bothers me” on a 5-point scale from Never[0] to Always[5]), with a TD defined as 3 (Sometimes) or worse. Objective tests included whole mouth and lateral taste intensity, identification, and hedonic scores for quinine, saline, citric acid, sucrose, monosodium glutamate, and water solutions. Data was collected at baseline, 2 weeks after surgery if applicable, and after RT at 3, 6, and 9 months of follow-up.

Results: Sixty-six cancer patients and 34 controls were enrolled (n=100). Forty-nine (74%) patients underwent surgery ± aRT and 17 (26%) underwent CRT. At baseline, TD prevalence was 2/34 (6%) in controls, 2/17 (12%) in the CRT group and 3/49 (6%) in the surgery group. TDs were present in 21/43 (49%) of surgery patients at 2-weeks post-operatively. TD prevalence peaked by 3 months after RT in both treatment groups (surgery 19/27 [70%] and CRT 6/9 [66%]) and subsequently declined. CGI had a negligible association with RT dose (Spearman’s rho = 0.18). All solution intensities had negligible association with CGI.

Conclusions: Oropharynx cancer patients should be counseled about high rates of TDs after treatment. Patients’ subjective taste changes are not reflected by traditional objective taste tests.