A MSKCC retrospective propensity-matched dosimetric analysis of 575 patients with HPV+ oropharyngeal cancer compared standard elective dosing (50–60 Gy) with a de-escalated 30 Gy approach with everyone receiving 70 Gy to gross disease. After matching 132 unilateral and 87 bilateral cases, the 30 Gy cohort demonstrated across-the-board reductions in dose to organs at risk, namely mean ipsilateral/contralateral parotid doses, submandibular glands, oral cavity, and larynx. Notably, the largest relative improvements were seen for the contralateral parotid (-40%) and larynx (-33%), which makes sense as they are likely distant from 70 Gy fall-off. We await large prospective non-inferiority trials re: efficacy which are currently in the works. | Miller, Int J Radiat Oncol Biol Phys 2026
