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

Purpose To report rapid recovery of treatments-related dysgeusia after Tongue-Out Radiotherapy (TORT) for head and neck cancer (HNC). Method and material We retrospectively reviewed 14 HNC patients who completed TORT with 70 Gy for definitive or salvage and 60-66 Gy for adjuvant treatment with or with concurrent chemotherapy. Patient-reported quality of taste was evaluated before, at the end of TORT and periodically 1, 3, and 6 months after TORT using University of Washington Quality of Life questionnaire version 4, question 9 including options for no-, mild-, severe-dysgeusia, and ageusia. Oral cavity (OC) and oral tongue (OT) were contoured following guidelines. A portion of anteriorly displaced OT outside the mouth was separately contoured as OT OUT . Statistical analysis was conducted with the Chi-square and t-test. A probability level of p < 0.05 was considered significant. Results In 14 TORT plans, average volume of OC and OT was 105.8 ± 25.3 and 67.6 ± 20.7 cm 3 , respectively. OT OUT comprised 20% (13.4 ± 9.1 cm 3 ) of the entire OT volume. Average mean dose (D MEAN ) to OC, OT and OT OUT 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) vs 14% (n=2) of patients, respectively; 14% (n=2) vs 86% (n=12) at the end of TORT ( p