of the patient. The source of salivary following suggestions could production during periods help to reduce taste changes and losses and TABLE 1. Summary of effects possible subsequent of radiation therapy diminishing of appetite. Food Intake, and Region Acute effects Nutrition: Chronic effects Suggestions for Their Improvement Central Nausea, vomiting l . Psychologic trauma nervous occurs even before system treatment begins and thus Head and neck Mucositis, sore Xerostomia, loss of interest in eating declines. mouth and taste, dental Patient should be told what to expect during throat, caries, ulcer, treatment. It is important dysphagia, osteoradionecrosis, that the patient understands when to odynophagia, trismus expect improvement in his dry or her conditions as a (xerostomia), function of time. Acute and loss of taste chronic effects are listed in (hypo-I Table l . A state of hope is ageusia), very important. dysgeusia, Tolerance dose, dysosmia, fractionation pattern, and anorexia target volume must be Thorax Dysphagia Fibrosis, stenosis, selected with attention to perforation, fistula minimum damage to Abdomen and Anorexia, Diarrhea, salivary and taste organs nausea. maldigestion, when using radiation. vomiting, maiabsorption, Selective shieldings of parotid glands as well as diarrhea, acute chronic enteritis, some of the taste buds are most important. enteritis, acute chronic colitis: Mucositis appears colitis, ulcer, stricutret during irradiation treatment but also choleretic obstruction, declines sooner than taste dysfunction. Bland foods enteropathy diarrhea, with neutral pH are best perforation, fistula tolerated. Milk is a good food source under these of sensory stimulation. conditions. Alcohol should Artificial saliva should be be forbidden. suggested to patients, but Severe xerostomia it is of limited use. Since can be of long duration severity of xerostomia is and should be avoided if directly related to total possible. The parotid radiation dose and to glands are the major volume of salivary gland irradiated, adequate
of the patient. The following suggestions could help to reduce taste changes and losses and possible subsequent diminishing of appetite. Food Intake, and Nutrition: Suggestions for Their Improvement l . Psychologic trauma occurs even before treatment begins and thus interest in eating declines. Patient should be told what to expect during treatment. It is important that the patient understands when to expect improvement in his or her conditions as a function of time. Acute and chronic effects are listed in Table l . A state of hope is very important. Tolerance dose, fractionation pattern, and target volume must be selected with attention to minimum damage to salivary and taste organs when using radiation. Selective shieldings of parotid glands as well as some of the taste buds are most important. Mucositis appears during irradiation treatment but also declines sooner than taste dysfunction. Bland foods with neutral pH are best tolerated. Milk is a good food source under these conditions. Alcohol should be forbidden. Severe xerostomia can be of long duration and should be avoided if possible. The parotid glands are the major source of salivary production during periods TABLE 1. Summary of effects of radiation therapy Region Acute effects Chronic effects Central nervous system Nausea, vomiting Head and neck Mucositis, sore Xerostomia, loss of mouth and taste, dental throat, caries, ulcer, dysphagia, osteoradionecrosis, odynophagia, dry (xerostomia), loss of taste (hypo-I ageusia), dysgeusia, dysosmia, anorexia trismus Thorax Dysphagia Fibrosis, stenosis, perforation, fistula Abdomen and Anorexia, Diarrhea, nausea. maldigestion, vomiting, maiabsorption, diarrhea, acute chronic enteritis, enteritis, acute chronic colitis: colitis, ulcer, stricutret choleretic obstruction, enteropathy diarrhea, perforation, fistula of sensory stimulation. Artificial saliva should be suggested to patients, but it is of limited use. Since severity of xerostomia is directly related to total radiation dose and to volume of salivary gland irradiated, adequate
Beidler%20Smith%201991_Effects%20of%20Radiation%20Therapy%20and%20Drugs%20on%20Cell%20Turnover%20and%20Taste.docx