151751-Najiba-Chargi

192 CHAPTER 10 Early screening to identify patients with occult low SMM combined with multimodal inter- ventions may offer an improvement in treatment tolerance. In order to improve treatment tolerance to chemoradiotherapy in patients with LA-HNC two possible solutions are worth investigating: I. A new concept of cisplatin drug dosing schedules per kilogram of LBM using C3 muscle area measured on CT or MRI and II. SMM improvement by a multimodal approach including physical exercise (aerobic and resistance training), nutritional supplements (high protein) and pharmacological agents (anti-inflammatory, detoxifying agents). In conclusion, the current method of dosing cisplatin in patients with LA-HNC leads to ob - served high frequency of DLT whichmay impair tumor treatment and definitely impairs quality of life. Low SMM at diagnosis is highly predictive for DLT. Cisplatin dosing based taking SMM into account may be a promising new concept in HNC in order to improve treatment tolerance.