{"entity":{"id":"paper-e3311-transoral-surgery-ferris-jco-2022","kind":"paper","name":"ECOG-ACRIN E3311: transoral surgery followed by reduced-dose radiotherapy for HPV-positive oropharyngeal cancer","aka":[],"tldr":"In HPV-positive oropharyngeal cancer removed by transoral robotic surgery, patients with intermediate-risk pathology did just as well with a reduced 50 Gy dose of radiotherapy as with the standard 60 Gy, supporting surgery-based de-escalation.","summary":"Phase 2 trial of 495 patients with resectable HPV-positive oropharyngeal cancer treated with transoral surgery and neck dissection, then allocated by pathology: observation for low risk, randomisation to 50 or 60 Gy radiotherapy for intermediate risk, and chemoradiotherapy for high risk.\n\nTwo-year progression-free survival was 96.9 percent with observation, 94.9 percent with 50 Gy and 96.0 percent with 60 Gy, and 90.7 percent with chemoradiation, with better swallowing outcomes at lower doses.","asOf":"2026-09-17","links":[{"label":"J Clin Oncol 2022","url":"https://doi.org/10.1200/JCO.21.01752"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/34699271/"}],"tags":[],"related":[],"cancers":["hpv-positive-oropharyngeal-cancer"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2022,"doi":"10.1200/JCO.21.01752","pmid":"34699271","authors":"Ferris RL, Flamand Y, Weinstein GS, et al.","paperType":"rct","findings":["Two-year progression-free survival 94.9 percent with 50 Gy vs 96.0 percent with 60 Gy in intermediate-risk patients.","Low-risk patients observed after surgery had 96.9 percent two-year progression-free survival."],"whatItMeans":"Transoral surgery with pathology-guided reduced-dose radiotherapy is a validated de-escalation pathway for HPV-positive oropharyngeal cancer in experienced centres.","caveats":["Phase 2 with no non-surgical comparator.","Requires surgical expertise with low positive-margin rates."],"changedPractice":true,"participants":495},"route":"/key-papers/paper-e3311-transoral-surgery-ferris-jco-2022/","neighbours":{"cancer":[{"id":"hpv-positive-oropharyngeal-cancer","kind":"cancer","name":"HPV-positive oropharyngeal cancer","route":"/cancers/hpv-positive-oropharyngeal-cancer/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}]}}