Grant: Project Grant

Oropharyngeal squamous cell carcinoma (OPSCC) that is related to human papillomavirus (HPV) infection is increasing in incidence within Canada and worldwide. OPSCC is now the most common category of head and neck squamous cell carcinoma and the most common HPV-related malignancy in Canada. Standard treatment of HPV-related OPSCC includes radiotherapy (RT) often with concurrent chemotherapy (CRT). These treatments are highly effective at curing most patients with HPV-related OPSCC, but side effects from treatment can be severe and long lasting. Various approaches have been taken to reduce side effects from treatment in recent years, but more progress is needed. One approach that has not been sufficiently evaluated is to reduce the regions of the lymph nodes in the neck that are treated with radiotherapy. The purpose of the proposed study is to test this new treatment approach in patients with HPV-related oropharynx cancer who have a favourable prognosis. All enrolled patients will be treated with standard doses of radiotherapy. The number of lymph node regions in the neck that are treated will be reduced with the goal of minimizing side effects. Patients will be followed after treatment to assess cure rates, side effects, ability to swallow, quality of life, and impact of therapy on their use of medical and supportive resources. We will also evaluate the likelihood of cancer recurrence within the lymph node regions of the neck that were left untreated as part of the study design.