This randomized phase II trial studies the side effects and how well modestly reduced-dose intensity-modulated radiation therapy (IMRT) with or without cisplatin works in treating patients with oropharyngeal cancer that has spread to other places in the body (advanced). Radiation therapy uses high energy x rays to kill tumor cells. Drugs used in chemotherapy, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether IMRT is more effective with or without cisplatin in treating patients with oropharyngeal cancer.
A Randomized Phase II Trial for Patients With p16 Positive, Non-Smoking Associated, Locoregionally Advanced Oropharyngeal Cancer
I. To select the arm(s) achieving a 2-year progression-free survival rate of>= 85% without unacceptable swallowing toxicity at 1 year.
I. To determine patterns of failure (locoregional relapse versus distant) and survival (overall and progression-free) at 6 months and 2 years.
II. To determine acute toxicity profiles at the end of radiation therapy and at 1 and 6 months.
III. To determine late toxicity profiles at 1 and 2 years. IV. To determine patient-reported swallowing outcomes at 6 months and 1 and 2 years.
V. To determine the predictive value of 12-14 week, post-treatment fludeoxyglucose F 18 (FDG)-positron emission tomography (PET)/computed tomography (CT) for locoregional control and progression free survival (PFS) at 2 years.
VI. To determine the predictive value of blood and tissue biomarkers for disease outcomes at 2 years.
VII. To determine swallowing recovery per videofluoroscopy imaging at 2 years.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients undergo IMRT once daily (QD) five days a week for 6 weeks to a total dose of 60 Gy and receive cisplatin intravenously (IV) over 30-60 minutes weekly during radiation therapy for 6 doses in the absence of disease progression or unacceptable toxicity.
ARM II: Patients undergo IMRT five days a week for 5 weeks to a total dose of 60 Gy in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
Stage III Oropharyngeal Squamous Cell Carcinoma Stage IVA Oropharyngeal Squamous Cell Carcinoma Stage IVB Oropharyngeal Squamous Cell Carcinoma Stage IVC Oropharyngeal Squamous Cell Carcinoma Tongue Carcinoma Cisplatin Succinylcholine
Open to people ages 18 years and up
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