Trial reportInternational journal of radiation oncology, biology, physics2020
A Phase 2 Trial of Alternative Volumes of Oropharyngeal Irradiation for De-intensification (AVOID): Omission of the Resected Primary Tumor Bed After Transoral Robotic Surgery for Human Papilloma Virus-Related Squamous Cell Carcinoma of the Oropharynx.
Trial report in International journal of radiation oncology, biology, physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
85 citing papers in PubMed, 4 syntheses or guidelines pooled it, 160 citations in OpenAlex.
- Oncologic Outcomes of Transoral Robotic Surgery in HPV-Associated OPSCC: A Systematic Review and Meta-Analysis.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Pooled it
- Radiotherapy integration after transoral robotic surgery in head and neck cancer: a bibliometric and knowledge-mapping analysis of adjuvant treatment, de-escalation, functional preservation, and survival outcomes.Frontiers in oncology · 2026Pooled it
- Update on completed and ongoing trials investigating TORS in head and neck oncology.Frontiers in oncology · 2026Pooled it
- Pooled it
- Upfront Neck Dissection for Treatment Selection and Improvement in Quality of Life as a Novel Treatment Paradigm for Deintensification in HPV+ OPSCC.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024Trial
- Hypoxia-Directed Treatment of Human Papillomavirus-Related Oropharyngeal Carcinoma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Trial
- Reduced-Dose Radiation Therapy for HPV-Associated Oropharyngeal Carcinoma (NRG Oncology HN002).Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021Trial
- Non-Metastatic Squamous Cell Carcinoma of the Oropharynx: Primary Surgery or (Chemo)radiotherapy?Head & neck · 2026Review
- Liquid Biopsy in Head and Neck Squamous Cell Carcinoma: A Molecular Perspective on Circulating Biomarkers and Their Clinical Translation.Current issues in molecular biology · 2026Review
- Nanopore Sequencing for HPV in Oropharyngeal Squamous Cell Carcinoma and Benign Tonsil Specimens.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Article
- Lack of De-Intensification Models for Female Head and Neck Cancer Patients With Favorable Prognosis.Cancer medicine · 2026Article
- Surgically Based Deintensification for Oropharyngeal Cancer: Current Concepts and Future Directions.Otolaryngologic clinics of North America · 2026Review
- Treatment Interruption and Outcomes in Head and Neck Cancer: A Secondary Analysis of 3 Randomized Clinical Trials.JAMA otolaryngology-- head & neck surgery · 2026Article
- Beyond stage and HPV status: the evolving landscape and future of multidisciplinary deintensification in human papillomavirus-related oropharyngeal cancer.BMJ oncology · 2026Review
- De-escalation of head-and-neck cancer radiotherapy: balancing cure and side effects.Frontiers in oncology · 2026Review
- Outcomes of HPV+ Oropharyngeal Carcinoma of Unknown Primary Following Transoral Robotic Surgery.The Laryngoscope · 2025Article
- Management of HPV+ head and neck squamous cell carcinoma with unknown primary in the era of treatment de-escalation.Oral oncology · 2025Article
- Tumor-intrinsic and immune-related features associated with treatment failure in human papillomavirus-related oropharyngeal cancer.Journal of the National Cancer Institute · 2025Article
- Circulating HPVDNA in patients undergoing transoral robotic surgery for oropharyngeal cancer: liquid biopsy could identify molecular residual disease.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Observational
25 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
22 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis trial tested the safety and efficacy of a novel, deintensified radiation therapy (RT) approach after initial surgical resection for patients with human papilloma virus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). METHODS AND MATERIALS: This single-arm phase 2 prospective clinical trial enrolled 60 patients with stage pT1-pT2 N1-3 HPV-associated OPSCC treated with transoral robotic surgery (TORS) and selective neck dissection at a single institution between May 2014 and September 2017. Patients had favorable features at the primary site (negative surgical margins ≥2 mm, no perineural invasion, and no lymphovascular invasion) but required adjuvant therapy based on lymph node involvement. Surgeries were all performed at a high-volume head and neck cancer center with expertise in TORS. Patients received postoperative RT to at-risk areas in the involved neck (60-66 Gy) and uninvolved neck (54 Gy). The resected primary site was treated as an active avoidance structure in the treatment planning of postoperative RT. Concurrent chemotherapy was administered for patients with extranodal extension.
resultsMedian follow-up of the 60 patients enrolled was 2.4 years (range, 8.5-53.8 months). A single patient recurred at the primary site, for 2-year local control of 98.3%. One patient (1.7%) developed a regional neck recurrence, and 2 patients (3.3%) developed distant metastases. Measured 2-year local recurrence-free survival was 97.9% (95% confidence interval, 86.1%-99.7%). Overall survival was 100% at the time of analysis. The mean radiation dose to the primary site was 36.9 Gy (standard deviation, 10.3 Gy). Two patients (3.3%) experienced late soft tissue necrosis in the primary site surgical bed that resolved within 2 months. Feeding tube dependence rates were 0% during RT, 3.3% temporarily during follow-up, and 0% at last follow-up.
conclusionsDeintensified postoperative RT that avoids the resected primary tumor site and targets only the at-risk neck after TORS for selected patients with HPV-associated OPSCC may be safe and is worthy of further study.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.