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Updated: May 28, 2026
Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019
Personalized volume de-escalated elective nodal irradiation in oropharyngeal squamous cell carcinoma (DeEscO): a
Esmée L Looman1,2, Yoel Pérez Haas1,2, Roman Ludwig1,2
1Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.
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.