Page 126 - Functional impairment and cues for rehabilitation of head and neck cancer patients -

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Chapter 5
Factors associated with functional limitations
Appendix 6 shows the baseline characteristics stratified by patients who did or did not have a modified diet (FOIS < 7) at t2. A modified diet at t2 was univariably associated with pretreatment lower BMI, lower SMI, sarcopenia, and a T4 tumor.
Appendix 7 shows the baseline characteristics stratified by patients who had trismus (mouth opening < 36 mm) at t2. Trismus at t2 was univariably associated with tumor site other than base of tongue and tonsil (i.e., soft palate, uvula, pharyngeal wall, vallecula, and pharyngeal arches).
Appendix 8 shows the baseline characteristics stratified by patients who had a vowel space below 80%, indicating abnormal articulation, at t2. A vowel space below 80% at t2 was univariably associated with a pretreatment vowel space area below 80% only.
HPV status
Appendix 9 shows the baseline characteristics stratified by HPV status. Compared to patients with an HPV negative tumor, patients with an HPV associated tumor had a higher BMI, higher SMI, lower T classifications, higher N classification, were more often treated with RT only, and had less often a modified diet at baseline.
Functional outcomes at t0, t1 and t2 stratified by HPV status are presented in Figure 5 and appendix 10. As presented in Figure 5a, at t1 and t2, patients with an HPV negative tumor more often had a modified diet compared to patients with an HPV positive tumor. Also, SWAL-QOL scores were higher in the HPV negative group at both t1 and t2. The prevalence of trismus was comparable between in het HPV negative and positive group at t1 and at t2 HPV negative patients had less often trismus compared to HPV positive patients. Patients with an HPV negative tumor had slightly worse speech and voice outcomes, especially at t1. After adjusting for T and N classification, treatment and pretreatment modified diet, none of the differences were statistically significant, except at t2, patients with an HPV positive tumor had a smaller mouth opening.