ArticleClinical and translational radiation oncology2026
Personalized volume de-escalated elective nodal irradiation in oropharyngeal squamous cell carcinoma (DeEscO): a study protocol.
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 NCT06563362 (Personalized Volume-deescalated Elective Nodal Irradiation in Oropharyngeal Head and Neck), which is not on this map. Not yet cited in PubMed.
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Personalized Volume-deescalated Elective Nodal Irradiation in Oropharyngeal Head and Neck
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15 authors.
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Abstract
Background: Definitive (chemo)radiotherapy of oropharyngeal squamous cell carcinoma (SCC) consists of treatment of the macroscopic tumor and prophylactic irradiation of the lymphatic drainage system: the elective clinical target volume (CTV). In this study, we reduce the elective CTV based on the personalized factors T-stage, clinical lymphatic involvement, and lateralization of the primary tumor. Methods: The primary objective is to evaluate efficacy and safety of an individualized de-escalation of elective node irradiation volumes. We collected a multi-institutional dataset of 598 oropharyngeal SCC patients in whom detailed lymph node involvement was reported. Based on the data, we developed a model of lymphatic tumor progression to estimate the probability of occult metastases in the clinically negative lymph node levels (LNLs). The dataset can be visualized on https://lyprox.org/. Based on this model and clinical judgement, we created tables that define the personalized elective CTV for different combinations of T-stage, midline extension and clinical LNL involvement. The primary endpoint of this multicentric, prospective, single-arm trial is the rate of out-of-field nodal recurrences after 2 years. The study will be conducted in 6 centers across Switzerland and 120 patients will be enrolled. Discussion: This study sets out to personalize the elective CTV in oropharyngeal SCC patients, with the goal to de-escalate radiotherapy for patients and herewith improve therapy-associated toxicity and quality of life. The results of this study may be used to personalize treatment in oropharyngeal SCC patients. Trial registration: The trial was registered on ClinicalTrials.gov NCT06563362, on 20/08/2024. Ethical approval was obtained on 21/01/2025, BASEC-Nr 2024-01936. Protocol Version 2.1, 12/05/2025.
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