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The effect of chemotherapy on olfactory function and mucociliary clearance

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Abstract

Objectives

Olfactory sensory neurons and the olfactory mucosa are both important for optimal olfactory function. The potential nasal mucosal toxicity of chemotherapy regimens has not been assessed yet. The aim of this study was to objectively investigate the effect of chemotherapy on mucociliary clearance and olfactory function and to evaluate whether this effect differs between different chemotherapy regimens and age groups.

Patients and methods

The study included consecutive patients admitted for the treatment of a variety of primary tumors (except head and neck and brain malignancies). Patients were evaluated for olfaction and mucociliary clearance before and immediately after completing the last session of chemotherapy cycles, according to the therapeutic protocol. For objective evaluation, the saccharine test was used for mucociliary clearance and the Sniffin’ Sticks test for olfactory function. Of the 46 initial patients, 30 completed the study. Groups were formed according to the chemotherapy regimen (four groups: CA (doxorubicin + cyclophosphamide), Folfox (oxaliplatin +5-FU + folinic acid), DCF (docetaxel + cisplatin +5-FU), and GC (gemcitabine + cisplatin)) and according to age (two groups: < 55 years and > 55 years).

Results

In the overall analyses, significant deterioration was noted in both mucociliary clearance time and smell scores (olfactory threshold (OT), olfactory discrimination (OD), olfactory identification (OI), and the composite threshold–discrimination–identification (TDI) score). The changes in these scores showed no significant differences between chemotherapy groups. The decrease in OT and global TDI scores was more severe in the younger age group.

Conclusions

Chemotherapy impairs both the mucociliary clearance and olfactory function in cancer patients. This might reflect the collective negative effect of chemotherapy on olfactory function, not only through the neurocytotoxic effect but also the cytotoxic effect on the nasal mucosa. In addition, the reduction in olfactory threshold and total olfactory function scores was seen to be more profound in younger patients, which could have been due to higher initial scores.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey

    Fakih Cihat Eravcı, Kürşat Murat Özcan, Mustafa Çolak, Aykut Ikincioğulları & Hacı Hüseyin Dere

  2. Department of Otorhinolaryngology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey

    Fakih Cihat Eravcı

  3. Department of Medical Oncology, Ankara Numune Training and Research Hospital, Ankara, Turkey

    Gökhan Uçar, Yakup Ergün, Yusuf Açıkgöz & Doğan Uncu

Authors
  1. Fakih Cihat Eravcı
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  2. Gökhan Uçar
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  3. Kürşat Murat Özcan
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  4. Mustafa Çolak
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  5. Yakup Ergün
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  6. Yusuf Açıkgöz
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  7. Aykut Ikincioğulları
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  8. Doğan Uncu
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  9. Hacı Hüseyin Dere
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Fakih Cihat Eravcı, Gökhan Uçar, Mustafa Çolak, Yakup Ergün, and Yusuf Açıkgöz. Data analyses were performed by Fakih Cihat Eravcı and Aykut İkincioğulları. The first draft of the manuscript was written by Fakih Cihat Eravcı and all authors commented on previous versions of the manuscript. Critical editing was performed by Kürşat Murat Özcan, Doğan Uncu, and Hacı Hüseyin Dere. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Fakih Cihat Eravcı.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Ankara Numune Training and Research Hospital Ethical committee, No: E-18-2385 number) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

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Eravcı, F.C., Uçar, G., Özcan, K.M. et al. The effect of chemotherapy on olfactory function and mucociliary clearance. Support Care Cancer 29, 1635–1641 (2021). https://doi.org/10.1007/s00520-020-05639-y

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  • DOI: https://doi.org/10.1007/s00520-020-05639-y

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