Effect of Chemotherapy With Paclitaxel/Cisplatin on Development Dysgeusia in Non Small Cell Lung Cancer
Condition: Non-Small Cell Lung Cancer; Dysgeusia; Taste Disorders; Lung Neoplasms; Small Cell Lung Carcinoma
MeSH terms: Lung Neoplasms; Carcinoma, Non-Small-Cell Lung; Small Cell Lung Carcinoma; Taste Disorders; Dysgeusia
Study type: Observational

Summary: 
      One of the most widely used treatments for non-small cell lung cancer (NSCLC) is the
      combination of paclitaxel-cisplatin. These drugs may contribute to taste alterations like
      dysgeusia. Which alters the feeding of cancer patients, contributing to the anorexia, weight
      loss and malnutrition, which leads to a prognostic impact in a lower patient response to
      chemotherapy, radiotherapy and surgical treatment as well as increased toxic effects,
      impacting treatment discontinuation and therefore, morbidity and survival of patients. The
      objective of this study is to describe the threshold of perception and recognition of basic
      tastes in patients with NSCLC before treatment with platin and paclitaxel-based chemotherapy
      and after the second cycle, and analyze the effect in the developement of dysgeusia, as well
      as the association between these and the nutritional status and quality of life.
    

Detailed description: 
      Lung cancer is the leading cause of death from malignancies in our country. It was recently
      reported to induce 11.5% of cancer deaths in Mexico, with a rate of 6.5 per 100 000 people.

      Non-Small Cell Lung Cancer (NSCLC) accounts for 80% of all lung cancer cases. Less than 20%
      has resectable disease and in the National Cancer Institute of Mexico exclusively less than
      2%, representing chemotherapy the standard of care in these patients.

      One of the most widely used drug combinations is paclitaxel-cisplatin. It has been reported a
      prevalence of malnutrition in 60 to 79% in this type of cancer, being the major contributor
      to morbidity and mortality. The etiology resides both in the systemic effects of the tumor
      and toxic effects of treatment as low levels hematologic, nausea, vomiting, mucositis,
      anorexia, dysgeusia, among others.

      Weight loss has a strong impact on the response to chemotherapy, radiotherapy and surgery, as
      well as increased toxic effects impacting the discontinuation of treatment and is considered
      an independent predictor of survival for most patients with NSCLC. Is estimated that over 20%
      of cancer patients the cause of death are inanition effects.

      Among the most frequent symptoms in advanced unresectable cancer or its treatment that may
      affect food intake and hence nutritional status, are the early satiety and dysgeusia (61% and
      46% respectively). As are difficult to change early satiety, dysgeusia is a field for
      selecting strategies in its management.

      The dysgeusia is defined as a change in taste that can manifest as a distortion of taste,
      lack of taste (ageusia), decreased sensitivity of perception (hypogeusia) or increased
      sensitivity to some or all flavors (hypergeusia).

      The development of dysgeusia have clinical significance in the etiology of cancer anorexia
      because it can affect eating habits and contribute to weight loss or malnutrition and
      consequently affect the quality of life.

      The chemotherapy may contribute to dysgeusia. It has reported a prevalence of 56.3% of
      Dysgeusia in cancer patients under this type of treatment. As well, zinc deficiency has been
      associated with the hypogeusia, this metal to be involved at various levels in the physiology
      of the role of taste at various levels of cell several organization.

      Several studies have linked consumption dysgeusia with energy and macronutrients, weight
      loss, lack of appetite and early satiety.

      The type of tumor, stage, chemotherapy regimen and serum zinc levels are associated with
      dysgeusia, but the exact mechanism underlining these disturbances are not known at totality.
      No known if chemotherapy or before this is presented dysgeusia. In addition there are few
      studies in this area and with methodological weaknesses, among which include heterogeneous
      population (patients with a diagnosis of malignancy of breast, lung, prostate, multiple
      myeloma and lymphoma), different patterns of treatment(different chemotherapy drugs,
      radiotherapy schedules and combination of both forms of measurement of dysgeusia, besides the
      absence of dysgeusia baseline evaluation before chemotherapy to establish a causal
      association between chemotherapy and taste alteration.

      Also, is unknown if dysgeusia impact on body composition determined by bioelectrical
      impedance, phase angle in and consumption of micronutrients (iron, sodium, zinc, B6, B12).

      That's why is necessary to continue studying this phenomenon to develop a better
      understanding of the nature, frequency, severity and duration of dysgeusia in patients with
      advanced lung cancer, the role that zinc exerts in its development and its impact on
      consumption food, anthropometric parameters and quality of life in such patients before and
      after chemotherapy in the same regimen of chemotherapy.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Outpatients from National Cancer Institute with stage III and IV NSCLC candidates for 1 st
        line chemotherapy paclitaxel-cisplatin based agreeing to participate in the study.
      
Keywords: Non-Small Cell Lung Cancer; Dysgeusia; Antineoplastic Combined Chemotherapy Protocols; Paclitaxel; Cisplatin