Trial reportJournal of the National Cancer Institute2021
Precision Radiotherapy: Reduction in Radiation for Oropharyngeal Cancer in the 30 ROC Trial.
Trial report in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers.
What it found
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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
79 citing papers in PubMed, 155 citations in OpenAlex.
- Risk-adapted therapy guided by human papillomavirus (HPV) circulating tumor DNA in HPV-positive oropharyngeal cancer (ReACT 1.0): an exploratory phase II trial.Nature communications · 2026Trial
- Hypoxia-Directed Treatment of Human Papillomavirus-Related Oropharyngeal Carcinoma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Trial
- Initial Feasibility and Acute Toxicity Outcomes From a Phase 2 Trial ofInternational journal of radiation oncology, biology, physics · 2023Trial
- Randomized Phase II Study of Physiologic MRI-Directed Adaptive Radiation Boost in Poor Prognosis Head and Neck Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2022Trial
- Interleukin-6 as surrogate marker for imaging-based hypoxia dynamics in patients with head-and-neck cancers undergoing definitive chemoradiation-results from a prospective pilot trial.European journal of nuclear medicine and molecular imaging · 2022Trial
- Trial
- Impact of carbon-ion radiotherapy on tumor hypoxia detected byEuropean journal of nuclear medicine and molecular imaging · 2026Article
- STING predicts patterns of failure in locally advanced head and neck squamous cell carcinoma.JNCI cancer spectrum · 2026Article
- Beyond stage and HPV status: the evolving landscape and future of multidisciplinary deintensification in human papillomavirus-related oropharyngeal cancer.BMJ oncology · 2026Review
- Whole-genome sequencing-based characterization of endometrial serous carcinoma.Gynecologic oncology · 2025Article
- Article
- Painful Realities: Navigating the Complexities of Head and Neck Cancer Pain.Oral diseases · 2025Review
- Novel Therapeutic Strategies for Squamous Cell Carcinoma of the Head and Neck: Beyond EGFR and Checkpoint Blockade.Biomedicines · 2025Review
- Early Dynamics of Circulating Tumor HPV-DNA with Neoadjuvant Chemotherapy and Response-Adapted De-escalation in Human Papillomavirus-Associated Oropharyngeal Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2025Article
- HPV-driven cancer: from epidemiology to the HPV-driven tumor board proposal, everything you wanted to know but were afraid to ask.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Review
- Treatment strategies in human papillomavirus-related advanced penile cancer.Nature reviews. Urology · 2025Review
- Predicting and monitoring response to head and neck cancer radiotherapy using multimodality imaging and radiobiological digital twin simulations.Physics in medicine and biology · 2025Article
- Optimising hypoxia PET imaging and its applications in guiding targeted radiation therapy for non-small cell lung cancer: a scoping review.Journal of medical radiation sciences · 2025Article
- Online Radiotherapy: The Paradigm Shift to Real-Time Adaptive Radiotherapy.Deutsches Arzteblatt international · 2025Review
- DEHyART trial: Study protocol for phase 2 randomised controlled study assessing the role of dose escalation using [18F] fluoromisonidazole positron emission tomography/computed tomography in head and neck cancers.Ecancermedicalscience · 2025Article
19 more citing papers are in PubMed but not listed here.
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Authors and funding
43 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundPatients with human papillomavirus-related oropharyngeal cancers have excellent outcomes but experience clinically significant toxicities when treated with standard chemoradiotherapy (70 Gy). We hypothesized that functional imaging could identify patients who could be safely deescalated to 30 Gy of radiotherapy.
methodsIn 19 patients, pre- and intratreatment dynamic fluorine-18-labeled fluoromisonidazole positron emission tomography (PET) was used to assess tumor hypoxia. Patients without hypoxia at baseline or intratreatment received 30 Gy; patients with persistent hypoxia received 70 Gy. Neck dissection was performed at 4 months in deescalated patients to assess pathologic response. Magnetic resonance imaging (weekly), circulating plasma cell-free DNA, RNA-sequencing, and whole-genome sequencing (WGS) were performed to identify potential molecular determinants of response. Samples from an independent prospective study were obtained to reproduce molecular findings. All statistical tests were 2-sided.
resultsFifteen of 19 patients had no hypoxia on baseline PET or resolution on intratreatment PET and were deescalated to 30 Gy. Of these 15 patients, 11 had a pathologic complete response. Two-year locoregional control and overall survival were 94.4% (95% confidence interval = 84.4% to 100%) and 94.7% (95% confidence interval = 85.2% to 100%), respectively. No acute grade 3 radiation-related toxicities were observed. Microenvironmental features on serial imaging correlated better with pathologic response than tumor burden metrics or circulating plasma cell-free DNA. A WGS-based DNA repair defect was associated with response (P = .02) and was reproduced in an independent cohort (P = .03).
conclusionsDeescalation of radiotherapy to 30 Gy on the basis of intratreatment hypoxia imaging was feasible, safe, and associated with minimal toxicity. A DNA repair defect identified by WGS was predictive of response. Intratherapy personalization of chemoradiotherapy may facilitate marked deescalation of radiotherapy.
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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.