City of Hope Medical Center
This clinical trial studies the side effects and how well removing the planning tumor volume (PTV) from radiation therapy (RT) works in treating patients with head and neck squamous cell carcinoma (HNSCC). Standard therapy for HNSCC often involves giving RT with chemotherapy; however, this approach is associated with a high level of short- and long-term side effects. RT uses high energy x-rays, particles, or radioactive seeds to kill tumor cells and shrink tumors. RT is planned to be delivered based on three volumes of the tumor. The first is the gross tumor volume which is the area of the tumor that can be seen, felt, or measured on imaging. The second is the clinical tumor volume which includes the gross tumor volume as well as area beyond this to account for disease that cannot be seen on imaging and may have spread. The third is the PTV which includes an area beyond both the gross tumor volume and clinical tumor volume to account for errors that may happen during RT, such as setup error or movement. As the area between the clinical tumor volume and PTV is not cancer and current advances in RT have improved RT accuracy, researchers think that removing PTV from RT may lower side effects while still being an effective treatment. Removing the PTV from RT may safe, tolerable, and/or effective in treating patients with HNSCC.
PRIMARY OBJECTIVES: I. Describe the effect of eliminating PTV on locoregional control and marginal recurrence at 6 months in patients with HNSCC undergoing definitive RT, with or without chemotherapy. II. Describe the effect of PTV on early toxicity, PRO (patient reported outcomes) and QOL (quality of life) in patients with HNSCC undergoing definitive RT, with or without chemotherapy. SECONDARY OBJECTIVES: I. Describe the effect of eliminating PTV on locoregional control at 2 and 5 years in patients with HNSCC undergoing definitive RT, with or without chemotherapy. II. Describe the patter…
Inclusion Criteria: * Documented informed consent of the participant and/or Legally Authorized Representative * Assent, when appropriate, will be obtained and documented for adults lacking capacity per institutional guidelines * Age: ≥ 18 years * Eastern Cooperative Oncology Group (ECOG) ≤ 2 * Pathologically (histologically or cytologically) proven diagnosis of squamous cell carcinoma (including the histological variants papillary squamous cell carcinoma and basaloid squamous cell carcinoma but not neuroendocrine phenotype) of the oropharynx (tonsil, base of tongue, soft palate, or orophar…
Given concurrent chemotherapy
Undergo CT and/or FDG-PET/CT
Undergo laryngopharyngoscopy
Undergo FDG-PET/CT
Undergo IGRT without PTV
Undergo IMRT without PTV
Ancillary studies