Radiotherapy with Reduced Dose and Volume Using Sentinel Lymph Node Mapping for Head and Neck Squamous Cell Carcinoma with One-Sided Lymph Node Involvement

What this Trial Is About

Researchers are investigating head and neck squamous cell carcinomas HNSCC located in the oral cavity, oropharynx, larynx, or hypopharynx, specifically in patients with positive lymph nodes on only one side of the neck and no distant metastasis. The study focuses on evaluating two strategies the use of sentinel lymph node mapping to customize the areas of the neck to be irradiated and reducing the radiation dose. This research aims to decrease the volume and dose of radiation to the contralateral neck to minimize severe side effects while maintaining cancer control. Participants will undergo different radiotherapy approaches based on sentinel lymph node mapping results. If the scan shows drainage only on the tumor side and the tumor does not cross the midline, patients will receive radiation on the same side with a reduced dose, sparing the opposite side. If drainage to the opposite side is present, participants will be randomly assigned to either receive radiation to the entire lymph node level containing the sentinel node or only to the sentinel node itself, both at reduced doses. The treatment targets are adapted individually according to the lymph node drainage pattern. During the study, patients will be monitored for contralateral regional control over two years after radiotherapy. Quality of life questionnaires will be completed regularly during the first two years. Researchers will also assess normal tissue complication probability, local cancer control, overall survival, and radiotherapy-induced toxicity. The study includes imaging assessments and clinical evaluations to measure treatment effects and safety, with follow-up visits scheduled up to two years post-treatment.

Dose De-escalation and Sentinel LN Mapping Driven Radiotherapy of Contralateral Neck in Ipsilateral Node Positive HNSCC