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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 radiation

Concurrent chemotherapy: Weekly cisplatin 40 mg/m2 for 6 cycles

Nodal status

Node 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

Fractionation

Radiation 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 conditions

In patients > 70 years of age, standard fractionation (daily, Monday-Friday over 6 weeks) can be used at the discretion of the radiation oncologist

In 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.