Purpose
Concurrent chemo-radiotherapy (CCRT) for head and neck squamous cell carcinoma (HNSCC) induce salivary changes and taste and smell changes (TSC). This study aims to elucidate physical and biochemical characteristics of saliva and objective taste sensation measures in HNSCC survivors at least 1 year post definitive CCRT.
Methodology
Saliva of patients who were at least 1 year post CCRT for HNSSC were collected and analysed. Quantitative parameters measured using GC Saliva Check Buffer Test kit (GC Australasia) included buffering capacity, hydration, viscosity and pH. Stimulated saliva flow rate (SFR) was measured using salivette rolls. Varying concentrations of sweet, sour, bitter and salty standardised tastant solutions were used to quantify specific taste changes and total taste quality scores (TTQS) was calculated. TSC and quality of life (QOL) measures were obtained with Goldberg chemosensory (GCS) and Functional Assessment of Chronic Illness Therapy (FACIT) questionnaires. Statistical analysis for correlation was done using SPSS version 23.
Results
Eight patients were included in this preliminary analysis. Physical changes noted include hydration status (mean 5.875±3.044; normal<30seconds), viscosity (1.875±0.835; normal=1) and SFR (range 0.19-0.987; normal>0.2). Biochemical changes include pH (mean 6.338±0.532; normal 6.8-7.8) and buffering capacity (mean 7.500±2.928; normal 10-12). The TTQS ranged from 2-10 (best=10). Maximum change in taste sensation was seen in bitter (1.25±0.535, normal=3) and minimum change in sweet taste (2.5±0.535, normal=3). The QOL scores showed reduced values across all the domains in both the GCS and FACIT questionnaires. No correlation was noted between the quantitative parameters of saliva and TTQS. There was a significant correlation between social and functional domain of QOL scores with TTQS.
Conclusion
Survivors of HNSCC develop significant changes in biochemical and taste parameters of saliva which are associated with impaired QOL.