RecruitingOropharyngeal Cancer

SPECT-CT Guided ELEctive Contralateral Neck Treatment for Patients With Lateralized Oropharyngeal Cancer

Eligible age

18+ yrs

Accepts

All genders

Locations

12 states

Healthy volunteers

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About this study

This study is being done to answer the following question: Is the chance of cancer spreading or returning the same if radiotherapy to the neck is guided, by using a special imaging study called lymph node mapping (lymphatic mapping) Single Photon Emission Computed Tomography (SPECT-CT), compared to the usual treatment when radiotherapy is given to both sides of the neck?

Sponsor: Canadian Cancer Trials Group

You may qualify if…

✓ Patients with pathologically proven diagnosis of lateralized OPC (tonsil, tongue base, soft palate, or pharyngeal wall) not involving or crossing midline.
✓ HPV positive or negative (by p16 immunohistochemistry).
✓ Clinical stage T1-3 M0 (UICC/AJCC TNM 8th Edition). Nodal involvement may include no nodes or single or multiple ipsilateral lymph nodes (largest ≤6cm in maximum diameter)
✓ Radiological investigations within 8 weeks of registration:
✓ CT or MRI of the neck (with head imaging as indicated);
✓ PET-CT scan
✓ Chest CT scan
✓ Planned definitive RT or CRT with bilateral neck RT (patients planned for unilateral neck RT are excluded).

You may not qualify if…

✕ T1-T2 cancers isolated to the tonsil fossa (i.e. without any soft palate, tongue base, posterior pharyngeal wall or posterior tonsil pillar involvement) with no involved lymph nodes or with a single ipsilateral node \< 3 cm without extranodal extension.
✕ Tonsil or tongue base primary cancer who have previously undergone diagnostic palatine or lingual tonsillectomy with either complete excision or with no clinically apparent residual disease
✕ Previous head and neck cancer or multiple synchronous primary head and neck cancers
✕ Previous induction or neo-adjuvant chemotherapy.
✕ Previous radiation therapy to the head and neck or comprehensive neck dissection of at least 3 levels on either side (due to potential for disrupted lymphatic channels and drainage pathways). Patients who have had excisional biopsies of involved lymph nodes are eligible
✕ Radiotracer allergy
✕ Severe, active co-morbidity including any of the following:
✕ Chronic Obstructive Pulmonary Disease or other pulmonary illness requiring hospitalization within 30 days of registration