{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:59:39Z","timestamp":1790715579214,"version":"4.1.0"},"reference-count":38,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO Oncol Adv"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>E2399 showed higher response rates and survival for human papillomavirus\u2013associated (HPV+) oropharynx (OP) cancer than for HPV-negative OP cancer. E1308, a follow-up prospective phase II trial in patients with HPV+ OP, hypothesized that reduced radiation (54Gy) may achieve comparable tumor control in patients who achieve a complete clinical response to induction chemotherapy and that toxicities would be ameliorated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Acute and late toxicities for both E2399 and E1308 were recorded prospectively using a battery of patient-reported outcomes (PROs). General quality of life (QOL) PROs used on E1308 included KATZ-Index of Independence in Activities of Daily Living (ADL), Brief Fatigue Index, Instrumental Activities of Daily Living, Baecke, and Community Health Activities Model Program for Seniors Physical Activity Questionnaire; head and neck cancer-specific PROs were Functional Assessment of Cancer Therapy \u2013 Head &amp; Neck (FACT-HN) and the Vanderbilt Head and Neck Symptom Survey Version 2 (VHNSSv2). E2399 used the FACT-HN. Toxicities were correlated with both intensity-modulated radiation therapy (IMRT) dose (69.3Gy\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      54Gy) used on E1308 and with the IMRT technique used on E1308 versus three-dimensional conformal radiation therapy (3DRT) used on E2399.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Radiation dose reduction resulted in significantly decreased toxicities as detected with VHNNSv2 and FACT-HN PRO instruments. The VHNSSv2 showed that late symptoms are significantly reduced by lowering IMRT to 54Gy: eating solids (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .011), liquids (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004), voice changes (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .026), dry mouth (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02), and neck and shoulder movements (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03). FACT-HN showed less difficulty in eating solids at 6 months (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .054), as well as voice strength and quality (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .038). Comparing IMRT 69.3Gy with 3DRT 70Gy, the FACT-HN showed eating solids at 12 months (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0067) and greater ability to eat foods the patient liked (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0103) favored IMRT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Both radiation dose reduction and using IMRT decreased toxicities in a variety of QOL PROs. Head and neck\u2013specific PROs are more sensitive than general PROs. Interinstrument corroboration validates the FACT-HN and VHNSSv2 utility for treatment deintensification evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/oa-25-00134","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:59:14Z","timestamp":1790711954000},"source":"Crossref","is-referenced-by-count":0,"title":["Patient-Reported Toxicity With Radiation Deintensification in Human Papillomavirus\u2013Associated Oropharynx Cancer: ECOG-ACRIN E2399 and E1308"],"prefix":"10.1200","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8650-313X","authenticated-orcid":true,"given":"Anthony J.","family":"Cmelak","sequence":"first","affiliation":[{"name":"Vanderbilt University\/Ingram Cancer Center, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2150-6732","authenticated-orcid":true,"given":"Yael","family":"Flamand","sequence":"additional","affiliation":[{"name":"Dana Farber Cancer Institute\u2014ECOG-ACRIN Biostatistics Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanthi","family":"Marur","sequence":"additional","affiliation":[{"name":"H. 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