151751-Najiba-Chargi

315 Systemic therapy: skeletal muscle mass and functional outcomes INTRODUCTION The incidence of oropharyngeal cancer (OPC) has risen over the past decades, partially due to the rising incidence of human papilloma virus (HPV) associated cases. 1 In early stage OPC, sur - gery as well as radiotherapy (RT) are curative treatment options. 1,2 In more advanced stages, especially when the disease is technically and functionally irresectable organ preserving concurrent radiotherapy and systemic therapy (RT(+)) has become the common treatment modality. Despite advancement in treatment, e.g., Intensity Modulated RT (IMRT) and Volumetric Mod - ulated Arc Therapy (VMAT), and rehabilitation, e.g., the addition of prophylactic swallowing exercises to ameliorate functional sequelae related to the tumor and its treatment, negative side effects still do occur. Multiple studies have shown that RT(+) for OPC, although organ preserving, is accompanied with serious functional impairment and a decreased quality of life in the short- and long-term. 3–7 Apart from xerostomia, swallowing impairment (dysphagia), is the most important side effect, which can worsen over time or even develop years after treatmen. 4,7–10 Impairedmouth opening (trismus), also commonly occurs after radiation-based treatment for OPC. Incidence rates of trismus vary across studies including patients with all head and neck cancer sites treated with surgery and/or RT(+), but oropharyngeal localization of the tumor consistently seems a significant risk factor. 11–16 Besides, RT(+) of the oropharynx alsomay affect articulation and speech. 17 Finally, a potential increased risk of carotid stenosis and cerebrovascular accidents has also been documented after RT(+). 18 These negative side effects and the prolonged survival achieved with the improved treatment technologies over the last decades demand an increased awareness of functionality and quality of life after OPC treatment. Most functional results at one-year post treatment stay stable up until five years posttreat- ment, which makes functional status at one year posttreatment predictive of the four year thereafter. 19 Thorough knowledge on the course of functional limitations during the first year after RT (+) for OPC will thus aid in adequate pretreatment patient counseling, and the devel - opment and optimization of targeted and patient specific (preventive) rehabilitation proto - cols. Moreover, identification of risk factors might aid in the development of individualized rehabilitation programs. For example, the correlation of HPV status with functional outcome has never been studied but might be a factor. Also, pretreatment sarcopenia, i.e., low skeletal muscle mass, is associated with unfavorable outcomes after treatment for head and neck cancer, including decreased survival and increased long-term feeding tube dependency, and might also be related to other posttreatment functional impairments 20,21 The objective of this study was to present OPC patients’ objective and subjective swallowing function, mouth opening and speech data before and at six and twelve months after RT(+) (IMRT) combined with a dedicated preventive rehabilitation program, with special attention for the possible role of HPV and pretreatment sarcopenia. These data are relevant for the optimization of current rehabilitation protocols. 17