Tumor Upstaging With MRI for HPV-Associated Oropharynx Cancer: Implications for De-Escalation Trials.

Objectives: Human papillomavirus (HPV)-associated oropharynx cancer (OPC) requires accurate staging to guide treatment and de-escalation clinical trial enrollment. MRI provides superior soft tissue contrast and assessment of tumor depth of invasion compared with CT with contrast and FDG-PET/CT. This study aims to evaluate the prevalence of HPV-associated OPC tumor upstaging and newly identified retropharyngeal lymph node (RPLN) metastases with MRI.

Outcomes of Reduced Elective Nodal Radiation Dose and Volume for Laryngeal, Hypopharyngeal, and p16-Negative Oropharyngeal Cancers.

Background: Reducing elective nodal irradiation dose can decrease treatment toxicity and improve quality of life for head and neck cancer patients.

Methods: We determined the effectiveness of reducing elective radiotherapy doses to 40 Gy for a consecutive cohort of laryngeal, hypopharyngeal, and p16-negative oropharyngeal or unknown primary squamous cell carcinomas treated with concurrent chemoradiation. The primary outcome measure was solitary elective nodal recurrence.