Practical radiation oncology · 2026
Tongue-Out Radiation Therapy for Patients With Head and Neck Cancer Facilitated a Rapid Recovery From Post-Radiation Therapy Dysgeusia by Lowering Oral Tongue Dose.
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Kil Whoon Jong, Stiffler Ashley, Smith Wyatt, Cousins David
Аннотация
PURPOSE: To report the rapid recovery of treatment-related dysgeusia after tongue-out radiation therapy (TORT) for head and neck cancer (HNC).
METHODS AND MATERIALS: We retrospectively reviewed 14 patients with HNC who completed TORT with 70 Gy for definitive or salvage and 60 to 66 Gy for adjuvant treatment with or without concurrent chemotherapy. Patient-reported quality of taste was evaluated before, at the end of TORT therapy, and periodically 1, 3, and 6 months after TORT therapy using the University of Washington Quality of Life questionnaire version 4, question 9, including options for no-, mild-, and severe dysgeusia and ageusia. Oral cavity (OC) and oral tongue (OT) were contoured following guidelines. A portion of the anteriorly displaced OT outside the mouth was separately contoured as OTOUT. Statistical analysis was conducted with the χ2 and t test. A probability level of P < .05 was considered significant.
RESULTS: In 14 TORT plans, the average volume of OC and OT was 105.8 ± 25.3 and 67.6 ± 20.7 cm3, respectively. OTOUT comprised 20% (13.4 ± 9.1 cm3) of the entire OT volume. Average mean dose (DMEAN) to OC, OT, and OTOUT was 25.2 ± 6.9, 26.4 ± 6.8, and 13.3 ± 2.9 Gy, respectively. Before TORT, no-to-mild versus equal or higher than severe dysgeusia (≥ severe dysgeusia) was 86% (n = 12) versus 14% (n = 2) of patients, respectively; 14% (n = 2) versus 86% (n =12) at the end of TORT (P < .01); 57% (n = 8) versus 43% (n = 6) at 1-month post-TORT (P < .01); 79% (n = 11) versus 21% (n = 3) at 3-month post-TORT (P = .23) and 93% (n = 13) versus 7% (n = 1) at 6-month post-TORT (P = .18).
CONCLUSION: TORT displaced OT anteriorly, lowered DMEAN to OT, especially to OTOUT, and facilitated rapid regaining of sense of taste at 1-month post-TORT. Patient-reported quality of taste returned to the baseline at 3-month and 6-month post-TORT. Further randomized study to verify clinical advantages with TORT for HNC is warranted.
METHODS AND MATERIALS: We retrospectively reviewed 14 patients with HNC who completed TORT with 70 Gy for definitive or salvage and 60 to 66 Gy for adjuvant treatment with or without concurrent chemotherapy. Patient-reported quality of taste was evaluated before, at the end of TORT therapy, and periodically 1, 3, and 6 months after TORT therapy using the University of Washington Quality of Life questionnaire version 4, question 9, including options for no-, mild-, and severe dysgeusia and ageusia. Oral cavity (OC) and oral tongue (OT) were contoured following guidelines. A portion of the anteriorly displaced OT outside the mouth was separately contoured as OTOUT. Statistical analysis was conducted with the χ2 and t test. A probability level of P < .05 was considered significant.
RESULTS: In 14 TORT plans, the average volume of OC and OT was 105.8 ± 25.3 and 67.6 ± 20.7 cm3, respectively. OTOUT comprised 20% (13.4 ± 9.1 cm3) of the entire OT volume. Average mean dose (DMEAN) to OC, OT, and OTOUT was 25.2 ± 6.9, 26.4 ± 6.8, and 13.3 ± 2.9 Gy, respectively. Before TORT, no-to-mild versus equal or higher than severe dysgeusia (≥ severe dysgeusia) was 86% (n = 12) versus 14% (n = 2) of patients, respectively; 14% (n = 2) versus 86% (n =12) at the end of TORT (P < .01); 57% (n = 8) versus 43% (n = 6) at 1-month post-TORT (P < .01); 79% (n = 11) versus 21% (n = 3) at 3-month post-TORT (P = .23) and 93% (n = 13) versus 7% (n = 1) at 6-month post-TORT (P = .18).
CONCLUSION: TORT displaced OT anteriorly, lowered DMEAN to OT, especially to OTOUT, and facilitated rapid regaining of sense of taste at 1-month post-TORT. Patient-reported quality of taste returned to the baseline at 3-month and 6-month post-TORT. Further randomized study to verify clinical advantages with TORT for HNC is warranted.