151751-Najiba-Chargi

288 CHAPTER 15 Our study has some limitations. Firstly, due to the retrospective design of the study not all information on potential confounding variables could be retrieved, such as life-stylemeasures including nutritional support and physical exercise. Nutritional support during CRTmay influ - ence the observed changes in SMM and their prognostic value. Secondly, we used routinely performed baseline and follow-up imaging and the time between the baseline and follow-up imaging therefore varied between patients, this may inherently lead to bias of the results. Thirdly, muscle function andmuscle strength were not measured in this study. However, these measures are also important in functional depletion and should be investigated further. Concluding, this study is the first to evaluate longitudinal SMM changes in patients with LA-HNC treated with cisplatin-based CRT and the first to identify risk factors for loss of SMM. Loss of SMM after CRT occurs in majority of LA-HNC patients. Overweight/obese patients and patients with oropharyngeal carcinoma are at increased risk for experiencing loss of SMM. Decreased risk of loss of SMMwas seen in patients who received CRT in a postoperative setting or who were able to withstand higher cumulative cisplatin doses.