Olfactory assessment in treatment and survivor groups of pediatric solid malignancies

Children with cancer who have received or are receiving chemotherapy and radiotherapy are at risk of serious effects of their treatments. Although most of these problems are well documented, the same cannot be said for the sense of smell. We aimed to determine whether there is a decrease in smell function in children with solid tumor malignancies who are currently undergoing or are survivors, using a specially designed, validated quantitative smell test for children. Sixty children with solid tumor (31 post-treatment and 29 current treatment) and 25 healthy controls were administered the Pediatric Smell Wheel®. Health-related quality of life (QOL) was assessed using the Pediatric Quality of Life Inventory (PedsQL). The cancer study group had significantly lower PSW scores than the control group [respective means (95% CIs) = 8.85 (8.43;9.17) and 10.32 (9.91;10.73); p < 0.001]. Twenty-two (36%) had scores less than 9, indicating the presence of olfactory dysfunction. PSW scores did not differ between patients with or without surgery and with or without radiotherapy (respective ps = 0.51 and 0.94). A weak positive correlation between PSW scores and the self-ratings of smell ability was present (r = 0.28, p = 0.02). Although lower QOL scores were found for the study group than for the controls for each domain (p < 0.01), such scores were not significantly correlated with those of the PSW. This study demonstrates that treatments for solid tumors of a variety of types significantly impact the ability of children to smell. The real-life implications of such deficits are yet to be determined.