Taste dysfunction following radiotherapy to the head and neck: A systematic review

Highlights: • Taste dysfunction is common, affecting 70–90% of people during radiotherapy with bitter and salt taste qualities affected most severely. • Taste dysfunction typically recovers partially post-radiotherapy but usually there is lingering dysfunction months to years after radiotherapy. • Minimising radiotherapy dose to the oral cavity and, specifically, the anterior two-thirds of the tongue is likely to reduce the risk of taste dysfunction. • Proton beam therapy and bite blocks may help to achieve this risk reduction. • Taste dysfunction is associated with a number of clinically important sequelae, including weight loss, xerostomia and reduced quality of life. An intact sense of taste provides pleasure, supports sustenance and alerts the body to toxins. Head and neck cancer (HNC) patients who receive radiotherapy (RT) are high-risk for developing radiation-induced taste dysfunction. Advances in RT offer opportunities for taste-preserving strategies by reducing dose to the gustatory organs-at-risk.