Dose-dependent taste dysfunction in head and neck cancer patients receiving radiotherapy

This study aimed to investigate the progression of taste dysfunction (TD) in patients with head and neck cancer (HNC) receiving radiotherapy (RT) and to develop a normal tissue complication probability (NTCP) model for predicting TD. A cross-sectional study was conducted on August 23rd and 24th, 2023. Eligible participants included newly diagnosed, pathologically confirmed HNC patients without distant metastasis. Acute toxicities were assessed via the NCI CTCAE v5.0, and taste acuity was evaluated via the Subjective Total Taste Acuity (STTA) Scale. Radiation dose data for organs at risk (OARs) were collected. Descriptive statistics and multivariate logistic regression were employed to develop the NTCP models. Among the 444 participants, 265 (60%) experienced TD with a CTCAE grade ≥ 2. Acute TD was significantly associated with body mass index (BMI) (OR: 0.936, P = 0.029). The mean dose (Dmean) of the parotid glands was the most predictive factor (AUC: 0.72) for acute TD. The tolerance dose of 50% for the parotid glands to develop acute TD ≥ 2 during RT was 24 Gy. The Dmean of the parotid glands to the predicted 10%, 30% and 50% probabilities of long-term TD were 45, 78 and 94 Gy after 3 months and 80, 97 and 105 Gy after 6 months, respectively. A lower BMI was significantly associated with TD, and a significant correlation was observed between TD and quality of life (QoL). The incidence of TD is closely related to the radiation dose, and reducing the dose to the parotid glands can lower the risk.