This study is being done to answer the following question:
Is the chance of cancer spreading or returning the same if radiotherapy to the neck is guided, by using a special imaging study called lymph node mapping (lymphatic mapping) Single Photon Emission Computed Tomography (SPECT-CT), compared to the usual treatment when radiotherapy is given to both sides of the neck?
Patients with pathologically proven diagnosis of lateralized OPC (tonsil, tongue base, soft palate, or pharyngeal wall) not involving or crossing midline.
HPV positive or negative (by p16 immunohistochemistry).
Clinical stage T1-3 M0 (UICC/AJCC TNM 8th Edition). Nodal involvement may include no nodes or single or multiple ipsilateral lymph nodes (largest ≤6cm in maximum diameter)
CT or MRI of the neck (with head imaging as indicated);
T1-T2 cancers isolated to the tonsil fossa (i.e. without any soft palate, tongue base, posterior pharyngeal wall or posterior tonsil pillar involvement) with no involved lymph nodes or with a single ipsilateral node < 3 cm without extranodal extension.
Tonsil or tongue base primary cancer who have previously undergone diagnostic palatine or lingual tonsillectomy with either complete excision or with no clinically apparent residual disease
Previous head and neck cancer or multiple synchronous primary head and neck cancers
Previous induction or neo-adjuvant chemotherapy.
Parallel
Lymphatic Mapping with SPECT-CT
Other interventionRadiation: Ipsilateral Neck Radiotherapy and SPECT-CT Guided Contralateral Neck Radiotherapy
Ipsilateral and Contralateral Neck
RadiationRadiotherapy
Disease-free Survival
Quality of Life using M.D. Anderson Dysphagia Inventory (MDADI)
Possible range of scores between 0 and 100 (higher scores indicating better swallowing and lower score indicating poor swallowing).
Xerostomia-related Quality of Life using Xerostomia Questionnaire (XQ)
Clinically meaningful worsening of xerostomia (10 units on XQ) from baseline to 12 months post RT
Isolated contralateral neck failure (iCNF)
Overall Survival (OS)
Click on the lead sponsor to view all of their trials.
Canadian Cancer Trials Group
Lead sponsor
Alliance for Clinical Trials in Oncology
Collaborator
Eastern Cooperative Oncology Group
Collaborator
NRG Oncology
Collaborator
SWOG Cancer Research Network
Collaborator
