Exploring the Role of Oxidative Stress in Metallic Taste During Head and Neck Cancer Treatment: A Study of Salivary Malondialdehyde and Therapeutic Interventions

IntroductionHead and neck cancers (HNC) treatments often cause a metallic taste (MT), adversely affecting patients quality of life. This study aims to investigate the lipoperoxidation hypothesis of MT by examining salivary malondialdehyde (MDA) levels, a marker of oxidative stress, in HNC patients undergoing treatment. MethodsThis prospective cohort study included 44 newly diagnosed HNC patients. Saliva samples were collected before, during and up to one year after the HNC treatment. Analyses including MDA and other markers were performed. Additionally, a bovine lactoferrin mouthwash was evaluated for its efficacy in alleviating MT. ResultsOut of the 44 patients, 12 (27.2%) reported MT, primarily during treatment phases. Salivary MDA levels significantly increased during radiotherapy, peaking mid-treatment, before declining post-treatment. Despite this fluctuation, no significant relationship was found between MDA levels and MT. Bovine lactoferrin mouthwash alleviated MT at least partially in 63.2% of the occurrences. Other salivary markers such as protein concentration, antioxidant properties, catalase activity, and superoxide dismutase activity showed no significant link to MT. DiscussionThe increase in MDA levels during radiotherapy indicated heightened oxidative stress. However, the lack of a significant association between MDA and MT suggests other factors may contribute to MT development. The partial efficacy of lactoferrin mouthwash highlighted a potential benefits. Future research should explore other mechanisms, such as the role of oral microbiota, to better understand and manage MT in HNC patients.