Lowering Radiation Dose for HPV-Related Oropharyngeal Cancer Using FMISO PET and MRI Scans A Study to Compare Standard and Reduced Radiation Treatments

What this Trial Is About

Researchers are studying HPV-associated oropharyngeal squamous cell carcinoma that shows no hypoxia on FMISO PET scans to see if treatment with a lower radiation dose is effective. The trial aims to find out the rate of complete tumor response after reduced radiation, how MRI and FMISO PET scans compare in detecting tumor oxygen levels, the side effects of reduced radiation, quality of life after treatment, and rates of cancer recurrence locally and in other areas. Patients with specific tumor stages will have surgery followed by either standard or lower radiation therapy based on FMISO PET results. Participants will be grouped by tumor oxygen levels shown on FMISO PET scans before and during radiation. Those without hypoxia will receive a lower radiation dose 30Gy with concurrent cisplatin chemotherapy, followed by mandatory neck dissection 3-4 months after radiation to assess tumor response. Patients with hypoxic tumors will receive standard radiation 70Gy with chemotherapy. Additional MRI scans will be done but will not affect treatment decisions. All patients will have a PETCT scan three months after radiation as part of usual care. During the study, participants will undergo various imaging procedures including FMISO PETCT, MRI before and during radiation, and FDG-PETCT after treatment. Researchers will track tumor response through pathology after surgery, measure quality of life regularly up to five years, monitor tumor control in the head and neck area, and record side effects from treatment both during and after radiation. Follow-up will continue for a minimum of five years to assess long-term outcomes.

De-escalation of Radiation Dose in HPV-associated OPC Utilising FMISO PET (DE-RADIATE)