Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2022
Phase II Randomized Trial of Transoral Surgery and Low-Dose Intensity Modulated Radiation Therapy in Resectable p16+ Locally Advanced Oropharynx Cancer: An ECOG-ACRIN Cancer Research Group Trial (E3311).
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 229 papers, 13 of them syntheses that pooled it.
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.
Phase II Randomized Trial of Transoral Surgical Resection Followed by Low-Dose or Standard-Dose IMRT in Resectable p16+ Locally Advanced Oropharynx Cancer
Surgery for the Unknown Primary in the Era of p16-positive Oropharyngeal Squamous Cell Carcinoma: Reducing Ionizing Radiation (SUPERIOR): A Randomized Trial
Who cites it
229 citing papers in PubMed, 13 syntheses or guidelines pooled it, 405 citations in OpenAlex.
- Effect of Smoking in Oropharyngeal Cancer Treated With TORS: Systematic Review and Meta-Analysis.The Laryngoscope · 2026Pooled it
- Biomarkers Associated With Extranodal Extension (ENE) in Oropharyngeal Squamous Cell Carcinoma (OPSCC): A Systematic Review.Head & neck · 2026Pooled it
- Transoral robotic surgery using the da Vinci single-port system: current evidence and clinical indications - a systematic review and meta-analysis.Journal of robotic surgery · 2026Pooled it
- Oncologic, functional, and economic outcomes of transoral robotic surgery for HPV-associated oropharyngeal squamous cell carcinoma: a systematic review and meta-analysis of pathology and treatment strategies.Journal of robotic surgery · 2026Pooled it
- Machine Learning to Predict Extranodal Extension in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.The Laryngoscope · 2026Pooled it
- 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
- Meta-analysis to Investigate the Correlation Between Event-Free Survival and Overall Survival in Patients with Resectable Locally Advanced Head and Neck Squamous Cell Carcinoma.Advances in therapy · 2025Pooled it
- Surgical margins after open versus transoral surgery for oropharyngeal cancer and their impact on the need for multimodal treatments.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2025Pooled it
- Histopathological Prognostic Factors of Surgically Treated HPV-Associated Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-analysis.Annals of surgical oncology · 2025Pooled it
- Evidence-based guideline diagnosis, treatment, prevention and aftercare of oropharyngeal and hypopharyngeal carcinoma.German medical science : GMS e-journal · 2025Guideline
- Surrogate endpoints in clinical trials of p16-positive squamous cell carcinoma of the oropharynx: an individual patient data meta-analysis.The Lancet. Oncology · 2024Pooled it
- Correlation between radiologic and pathologic extranodal extension in HPV-associated oropharyngeal cancer: Systematic review.Head & neck · 2022Pooled it
- Randomized, double-blind, sham-controlled trial of an intraoral photobiomodulation device for oral mucositis and associated complications due to radiotherapy for head and neck cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Trial
- 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
- FDG-PET-Based Selective Deescalation of Chemoradiation in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma: A Multicenter Phase II Trial.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Trial
- Correlation between imaging-detected and pathological extranodal extension in a randomised trial in Human Papillomavirus-positive oropharyngeal cancer.British journal of cancer · 2026Trial
- An exploratory study of nimotuzumab combined with toripalimab and chemotherapy for locally advanced tonsillar cancer.Frontiers in immunology · 2026Trial
- Long-Term Follow-Up of E3311, an ECOG-ACRIN Cancer Research Group Phase II Trial of Transoral Surgery and Risk-Based Adjuvant Treatment in Human Papillomavirus-Initiated Oropharynx Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Trial
- Postoperative Radiotherapy ± Cetuximab for Intermediate-Risk Head and Neck Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Trial
169 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
20 authors at 15 institutions in 1 country.
Funding
Abstract
purposeDefinitive or postoperative chemoradiation (CRT) is curative for human papillomavirus-associated (HPV+) oropharynx cancer (OPC) but induces significant toxicity. As a deintensification strategy, we studied primary transoral surgery (TOS) and reduced postoperative radiation therapy (RT) in intermediate-risk HPV+ OPC.
methodsE3311 is a phase II randomized trial of reduced- or standard-dose postoperative RT for resected stage III-IVa (American Joint Committee on Cancer-seventh edition) HPV+ OPC, determined by pathologic parameters. Primary goals were feasibility of prospective multi-institutional study of TOS for HPV+ OPC, and oncologic efficacy (2-year progression-free survival) of TOS and adjuvant therapy in intermediate-risk patients after resection. TOS plus 50 Gy was considered promising if the lower limit of the exact 90% binomial confidence intervals exceeded 85%. Quality of life and swallowing were measured by functional assessment of cancer therapy-head and neck and MD Anderson Dysphagia Index.
resultsCredentialed surgeons performed TOS for 495 patients. Eligible and treated patients were assigned as follows: arm A (low risk, n = 38) enrolled 11%, intermediate risk arms B (50 Gy, n = 100) or C (60 Gy, n = 108) randomly allocated 58%, and arm D (high risk, n = 113) enrolled 31%. With a median 35.2-month follow-up for 359 evaluable (eligible and treated) patients, 2-year progression-free survival Kaplan-Meier estimate is 96.9% (90% CI, 91.9 to 100) for arm A (observation), 94.9% (90% CI, 91.3 to 98.6]) for arm B (50 Gy), 96.0% (90% CI, 92.8 to 99.3) for arm C (60 Gy), and 90.7% (90% CI, 86.2 to 95.4) for arm D (66 Gy plus weekly cisplatin). Treatment arm distribution and oncologic outcome for ineligible or step 2 untreated patients (n = 136) mirrored the 359 evaluable patients. Exploratory comparison of functional assessment of cancer therapy-head and neck total scores between arms B and C is presented.
conclusionPrimary TOS and reduced postoperative RT result in outstanding oncologic outcome and favorable functional outcomes in intermediate-risk HPV+ OPC.
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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.