Radiotherapy Dose De-escalation in HPV-Associated Cancers of the Oropharynx

Summary

The purpose of this study is to use intra-treatment 18FDG-PET/CT during definitive radiation therapy for human papillomavirus (HPV)-related oropharyngeal cancer (OPC) as an imaging biomarker to identify and select patients with a favorable response for chemoradiation dose de-escalation. This study will prospectively evaluate the clinical outcomes for patients undergoing dose de-escalation.

Eligibility

Inclusion Criteria:

* Histologic documentation of squamous cell carcinoma of the oropharynx with p16-positive immunohistochemical staining and/or positive HPV in situ hybridization (ISH) and/or positive HPV PCR
* Stage I-III (AJCC 8th edition) with plan for concurrent chemotherapy per standard of care treatment
* Zubrod/ECOG score of 0-1
* Weight loss \<10% in the 3 months prior to diagnosis
* ≥ 18 years of age
* No prior chemotherapy for their current cancer diagnosis

Exclusion Criteria:

* Prior radiotherapy to the head and neck
* Medical contraindications to radiation therapy
* Absence of gross disease on imaging prior to beginning radiation therapy
* Distant metastatic disease
* Medical contraindication to PET/CT
* History of active cancer other than non-melanoma skin cancer within the last 5 years

Conditions2

Locations2 sites

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