Long-Term Results of a Phase 2 Clinical Trial of Radiation Volume and Dose Deintensification Following Transoral Robotic Surgery and Neck Dissection for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma.
Int J Radiat Oncol Biol PhysApr 16, 2026 (epub)
John N Lukens, Matthew D Riina, Gregory Weinstein et al.
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In 30 seconds
This phase 2 clinical trial evaluated reduced dose and volume adjuvant radiation therapy in 149 patients with HPV-associated oropharyngeal squamous cell carcinoma following transoral robotic surgery. At a median follow-up of 48 months, the estimated 5-year locoregional control rate was 98.0%, with no local recurrences reported.
Key findings
- The estimated 5-year locoregional control rate was 98.0% (95% CI, 95.3%-100%).
- Only 2 patients experienced regional recurrences, both of which were successfully salvaged.
- Distant metastases occurred in 10 patients (6.7%), with 3 (2.0%) dying of disease.
- Postoperative HPV ctDNA was linked to subsequent metastatic disease but not locoregional control.
Why it matters
The study demonstrates that a deintensified radiation approach can maintain high locoregional control rates while potentially reducing treatment-related toxicity in patients with HPV-associated oropharyngeal cancer, which may influence future treatment protocols.