151751-Najiba-Chargi

229 Systemic therapy: skeletal muscle mass and bioradiotherapy Figure 4. Kaplan Meier curve and number at risk table for patients with and without low SMM for dis - ease-free survival (Log Rank χ 2 = 2.191; p = 0.139) T = 0 T = 12 T = 24 T = 36 T = 48 T = 60 With low SMM 68 39 26 16 13 9 Without low SMM 23 13 12 10 7 5 DISCUSSION This study demonstrated that low SMM has a high prevalence in HNSCC patients with 74.7% of the patients included in this study. Additionally, roughly a third of the patients (30.8%) experienced cetuximab DLT. This study showed that weight loss of more than 10% in the six months prior to diagnosis as well as comorbidities as measured by the ACE-27 have predictive value for cetuximab DLT. However, no significant predictive value of low SMMwas observed for cetuximab DLT in HNSCC patients treated with cetuximab and radiotherapy. Furthermore, this study shows that low SMM may be of prognostic value in these patients for overall survival. The most commonly usedmethod for the measurement of SMM in cancer patients is based on measurement of the CSA of skeletal muscles on a single transversal slice at the level of the third lumbar vertebra (L3). 6 Swartz et al. found a correlation between the CSA of skeletal muscles at C3 and L3 (r = 0.785). 6 Using a multivariate prediction equation, the correlation between measured the CSA at L3 and estimated CSA at L3 fromC3 was even stronger (r = 0.895). There - fore, the CSA of skeletal muscles at the level of C3 can be used as an alternative to that of L3 to assess total SMM in patients who only received imaging of the head and neck area. 10 Moreover, an excellent inter-observer agreement for measurement of skeletal muscle CSA was found. 7 Additionally, a recent study demonstrated a strong correlation (r 2  = 0.94, p < 0.01) between 12