Routine Adaptive Replanning of p16-Positive Stage N2b Oropharyngeal Cancer: Quality Improvement or Waste of Time?

Purpose/Objective(s): To determine if routinely replanning patients treated for oropharyngeal cancer that is p16-positive and clinical neck stage N2b (AJCC 7th edition) is likely to result in dose changes that will improve patient outcomes to a meaningful degree. Methods: In 10 consecutive patients treated with primary radiotherapy (RT) and concurrent weekly chemotherapy for p16-positive N2b oropharyngeal carcinoma, we prospectively evaluated dose changes from replanning for the final 4 or 2 weeks of RT of a 7-week RT program. Results: Replanning for the final 4 or 2 weeks improved planning target volume coverage by an average of 4 and 2 percentage points, respectively. For all normal structures, the dose change was small (

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