ArticleClinical and translational radiation oncology2026
HYpofractionated, dose-redistributed RAdiotherapy (HYDRA) versus conventional radiotherapy for head and neck cancer: planned interim analysis and dosimetric comparison from the phase I HYDRA trial.
Article in Clinical and translational radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05364411 (HYpofractionated, Dose-redistributed RAdiotherapy With Protons and Photons to Combat Radiation-induced Immunosuppression in Head and Neck Squamous Cell Carcinoma), which is not on this map. Not yet cited in PubMed.
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HYpofractionated, Dose-redistributed RAdiotherapy With Protons and Photons to Combat Radiation-induced Immunosuppression in Head and Neck Squamous Cell Carcinoma (HYDRA)
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11 authors.
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Abstract
Purpose: (Chemo)radiotherapy for squamous cell carcinoma of the oropharynx, hypopharynx, and larynx results in significant treatment burden and may cause radiation-induced lymphopenia (RIL), which is associated with worse survival. We aim to reduce treatment burden and RIL using HYpofractionation and Dose-redistribution in patients treated with proton or photon RAdiotherapy (HYDRA, NCT05364411). Methods: Patients receiving curative (chemo)radiotherapy for cT1-4 N0-3bM0 oropharyngeal and hypopharyngeal carcinomas are eligible. Referral for proton therapy is determined by model-based selection (MBS) according to Dutch protocols, resulting in a HYDRA-proton and HYDRA-photon cohort. HYDRA in 20 fractions constitutes 40 Gy to the elective volume, 55 Gy to gross tumour volume (GTV) + 5 mm and 59 Gy to GTV - 3 mm. Safety interim analyses are conducted in each cohort when ten patients complete 6 months follow-up. The interim results determine trial continuation and expansion to inclusion of laryngeal carcinomas according to predefined dose limiting toxicities (DLT). Per included HYDRA-patient, we perform an intra-patient plan comparison of the HYDRA plan versus the conventional treatment plan that was used for MBS. Results: The HYDRA-photon interim analysis (reached in March 2024, Conclusions: The predefined interim analysis of HYDRA-photons showed one DLT. Per protocol, inclusion of laryngeal carcinomas in the photon cohort is now possible. The 20 fraction HYDRA schedule delivers a focal boost to the tumour with reduced dose to all organs at risk.
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