Treatment-Associated Changes in Taste Perception and PROP Bitterness Responsiveness in Children with Solid Tumors: Associations with Gastrointestinal Symptoms and Nutritional Risk

Taste dysfunction is increasingly recognized as a treatment-related adverse effect in pediatric oncology and may contribute to nutritional vulnerability. This prospective longitudinal study evaluated 60 children aged 8–18 years with solid tumors at an early-treatment baseline, defined as within the first month after diagnosis and following completion of the first chemotherapy cycle, and during treatment at months 2 and 4. Twenty healthy peers served as baseline controls. Self-reported taste alterations were assessed using a validated self-report instrument, and gastrointestinal symptoms and nutritional risk were evaluated using standardized scales. Subjective taste alterations increased during therapy, while objective PROP testing indicated progressively reduced bitterness responsiveness. Gastrointestinal symptom burden also increased significantly over time. Nutritional risk scores were positively correlated with both gastrointestinal symptom severity (r = 0.30–0.42, p < 0.05) and taste alteration scores (r = 0.28–0.43, p < 0.05). Children receiving multimodal treatment tended to exhibit more pronounced sensory alterations and higher nutritional risk. These findings suggest that treatment-associated taste changes co-occur with greater gastrointestinal symptom burden and higher nutritional risk in children with solid tumors. Longitudinal assessment of sensory changes may help identify patients at increased nutritional vulnerability during oncological therapy.