Prof. Hans Kaanders, Drs. Sven van den Bosch, Dr. Tim Dijkema (Radiation oncology) and Prof. Wim Oyen (Nuclear Medicine) have received a KWF grant (544.200,- euro) for a project entitled: Uniform FDG-PET guided GRAdient Dose prEscription to reduce late Radiation Toxicity (UPGRADE-RT): a randomised controlled trial with dose reduction to the elective neck in head and neck squamous cell carcinoma.
In definitive radiotherapy for head and neck cancer, clinically uninvolved cervical lymph nodes are irradiated with a so called ‘elective dose’ in order to achieve control of occult metastasis. As a consequence of high-resolution diagnostic imaging, occult tumour-load has significantly decreased in the last decades. Since the elective dose is dependent on occult tumour-load, the currently used elective dose may be higher than necessary. Elective treatment of nodal regions contributes significantly to short- and long-term radiation toxicity. For this reason, de-escalation of the elective radiation dose may open a window of opportunity to reduce toxicity and to improve quality of life without compromising tumour control.
UPGRADE-RT is a multicenter randomised controlled trial that will evaluate if de-escalation of the elective dose will result in less toxicity and an increased quality of life after treatment without compromising the recurrence rate in the electively treated neck.
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