CANUT Junior : Assessment of Sensory Abilities and Eating Behavior in Pediatric Oncology: a Feasibility Study

Overview

Cancer treatments in children are very intense and often cause side effects such as nausea, vomiting, loss of appetite, and changes in taste and smell. These sensory alterations can impact eating habits, but they are still poorly understood in children. The study aims to assess whether it is feasible to measure these sensory changes (taste, smell, salivation, and food preferences) in children and adolescents undergoing cancer treatment. This study is a feasibility study with 30 patients aged 7 to 17 years, treated at the Pediatric Hematology and Oncology Institute (IHOPE) in Lyon. Sensory tests and questionnaires to evaluate the perceptions, oral health, eating habits, nutritional status, and quality of life are used. The inclusion was initially planned at diagnosis, before any administration of chemotherapy. However, the study quickly encountered a recruitment problem due to the emotional impact and medical burden of this initial period of care (study offered to 11 families over a period of 5 months, 3 patients included). An amendment to the protocol was therefore made to be able to modify the inclusion period after the completion of chemotherapy. This modification was implemented on May 15, 2025, and allowed the inclusion of two new patients, making a total of 5 patients. Of these 5 patients, two completed all the tests during V0 and V1, two completed V0 but not V1, one did not complete any of the visits. This feasibility phase will help determine whether the tools are suitable and well accepted. The results will be used to design a larger study aimed at better understanding how taste and smell alterations influence the eating behaviors of young patients during cancer treatment. Recruitment will continue for six more months in order to reach the target number of participants.

Today, the chances of survival among children and adolescents who have been diagnosed with cancer are 80%, particularly due to early diagnosis and access to appropriate care. Although multimodal care strategies have improved the survival rate in pediatric patients, highly toxic treatments cause various short- and long-term side effects such as nausea, vomiting, loss of appetite, and alterations in taste perception. These side effects affect the comfort and quality of life of patients and expose them to a high risk of malnutrition. Sensory alterations related to smell, taste and texture reduce appetite and pleasure in eating, thus reducing food intake. More than 45% of children and adolescents treated for cancer suffer from malnutrition, which impacts their immune function, their response to treatments, their quality of life and even the costs of care. The consequences of sensory alterations on behaviors, preferences and eating habits are still little studied in children and adolescents treated for cancer. Similarly, olfactory and somesthetic capacities are very little explored in these patients. Only few studies are available in this area in pediatrics, and no studies take into account texture perception, which is essential for food acceptance. This study is a feasibility study aimed at exploring the tools for measuring sensory alterations. It aims to evaluate taste and olfactory capacities, as well as food preferences in terms of textures among children. The study is a single-arm intervention. The study will include 30 patients between 7 and 17 years old, newly diagnosed with oncological or hematological malignancies, treated at IHOPE (Institute of Hematology and Pediatric Oncology) in Lyon, until today 3 patients have been included. The protocol had to undergo a second session in the Ethics County for changes to the recruitment process on May 7, 2025, with the aim of having more inclusions of participants. The change consists of doing the tests before the second chemotherapy cycle instead of the first cycle since patients have a lot of procedures to do in hospital management and they did not agree to participate in the study. The measures that are taken are, olfactory and gustatory capacities, measurement of salivary quantity and quality, preference and acceptance of textures. The state of oral health, dietary habits and food consumption with questionnaires are also assessed. Measurements of weight, height and BMI are taken, and nutritional status is assessed. The Easy Assessment Score of Ingesta is also used for an early diagnosis of the risk of malnutrition or undernutrition and finally the quality of life with the help of a questionnaire.