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Table 1 Delivery of radiation ± chemotherapy depending on clinical nodal status in Arm 1 (Primary RT)

From: Treatment de-escalation for HPV-associated oropharyngeal squamous cell carcinoma with radiotherapy vs. trans-oral surgery (ORATOR2): study protocol for a randomized phase II trial

 Radiation Alone: Accelerated radiationConcurrent chemotherapy: Weekly cisplatin 40 mg/m2 for 6 cycles
Nodal statusNode negative (N0)
OR
Single node less than 3 cm in maximal diameter
Multiple lymph nodes
OR
Single lymph node more than 3 cm in maximal diameter
FractionationRadiation over 5 weeks, with 6 fractions a week
6th weekly fraction given on a weekday with a minimum 6 h intrafraction interval, or on a Saturday
Daily radiation, Monday-Friday over 6 weeks
Special conditionsIn patients > 70 years of age, standard fractionation (daily, Monday-Friday over 6 weeks) can be used at the discretion of the radiation oncologistIn patients who are deemed unfit for weekly cisplatin, the dose and/or schedule can be modified, or cetuximab or weekly carboplatin AUC 1.5 can be used, at the discretion of the medical oncologist.