The standard treatment for oropharynx cancer that does not contain the human papillomavirus (HPV) is high-dose radiation therapy plus the chemotherapy drug cisplatin. However, patients who receive this treatment are at risk of long-term speech and swallowing problems. Minimally invasive surgery to remove the cancer through the mouth (“transoral surgery”) and less intensive therapy afterward may be one way to reduce the risk of these side effects.
In this study, patients will be randomly assigned to either investigational therapy or standard therapy, and the groups will be compared. Patients in the investigational therapy group will first have transoral surgery to remove cancerous tissue, followed by either observation, radiation therapy (total dose of 60 Gy), or radiation therapy (60 Gy) plus six weeks of once-weekly cisplatin. Patients in the standard therapy group will receive a total dose of 70 Gy of radiation therapy followed by seven weeks of once-weekly cisplatin.