151751-Najiba-Chargi

347 Systemic therapy: skeletal muscle mass and functional outcomes DISCUSSION The objective of this study was to assess objective and subjective swallowing function, mouth opening and speech over a one-year period in a large cohort after RT (+) for advanced stage OPC treatment in conjunction with a dedicated preventive rehabilitation program, also fo - cusing on the role of HPV status and pretreatment sarcopenia. These results are relevant for the optimization of current rehabilitation protocols. Patients were treated with IMRT with or without systemic therapy and a concurrent preventive rehabilitation program. Data col - lection was part of a systematic, intensive routine monitoring program at our institute. The study showed that the normalcy of oral intake and SWAL-QOL scores first deteriorated up to six months, and subsequently improved up until twelve months after treatment, but did not return to baseline levels. Rate of feeding tube dependency in this cohort was low, with none of the patients being feeding tube dependent at one year after treatment. Also, very few patients experienced pneumonia during the one-year follow-up. Trismus and speech problems showed the same trend as swallowing function, with increased prevalence of problems at six-month follow-up, and lower – but still above baseline – prevalence rates at one-year post-treatment. Patients treated with cisplatin-based RT+, HPV negative tumors, and patients with pretreat - ment sarcopenia were more likely to have functional limitations. Patients treated with RT+ had worse swallowing, trismus and speech and voice outcomes, compared to those treated with RT alone. Most of the above summarized outcomes were in line with expectations and are comparable to those of other studies concluding that a substantial proportion of the patients have functional impairment after treatment. Although it is hard to compare the present results to other studies given the heterogeneity of cohorts and outcome measures currently used, some comparisons can be made. Starmer et al. evaluated 71 patients with OPC treated with IMRT with or without systemic therapy and preventive swallowing rehabilitation around 5 months post-treatment. 9 Probably because 92% of the patients received RT+, prevalence of a modified diet according to FOIS scores was higher in that study (86% compared to 34% in our study). Hunter et al. evaluated the two-year period after RT+ without preventive swallowing rehabilitation for stage III-IV OPC in 72 patients. 10 At six and twelve months after treatment respectively, 6% and 2% had grade 2 dysphagia (modified diet) and 6% and 1% had grade 3 dysphagia (feeding tube dependence) according to the Common Toxicity Criteria Adverse Effects (CTCAE) scale. The significantly lower percentage of patients with a modified diet in that study may, in part, be because another outcome measure was used (CTCAE scale versus FOIS). Congruent with our finding, other studies also found that functional limitations worsened the first months after therapy and improved through twelve months after treatment with minimal improvement in the year thereafter. 10,38 Only few studies have investigated trismus within the first year after radiation-based treatment and a preventive rehabilitation protocol for advanced stage OPC. Kraaijenga et al. found that 9 of 24 patients (27%) after RT+ for OPC had trismus at a median follow-up of 13 weeks. 15 In our 17