A Study of Radiation Therapy After Surgery in People With Oral Tongue Squamous Cell Carcinoma

Prior treatment

• Primary specimen surgical margin \< 3 mm (if \<WPOI 5, margin can be \>= 2.2mm)
• Prior or simultaneous invasive malignancy that, in the opinion of the PI, represents a competing risk of death equivalent to the patient's oral tongue squamous cell carcinoma.

Other illness

• N2c/N3 nodal disease
• Auto-immune conditions that would otherwise preclude radiation in the opinion of the PI (e.g. Scleroderma).

Other

• pT3 by size
• \>2 pathologically positive nodes
• Extensive Perineural Invasion (PNI); non-extensive PNI is permitted.
• Extra-capsular extension in any pathologically positive lymph node
• Lack of ability to understand and willingness to sign a written informed consent and complete questionnaires.

• Age ≥ 18
• Surgical resection of all gross disease without evidence of residual loco-regional disease on simulation PET/CT.
• pT1-2, or pT3 by DOI, pN0-2b Squamous Cell Carcinoma of the Oral Tongue confirmed on final surgical pathology. Patients must have:
  • at least two of the following pathologic risk features
  • LVI
  • DOI ≥ 4mm and ≤ 10mm OR
  • 1 or 2 pathologically positive nodes N1 to low volume N2b. OR DOI \>10 mm OR
  • \<=cT3N2b who undergo induction with near pCR (\<5% viable) or pCR at primary site
• Primary specimen surgical margins ≥3 mm (if \<WPOI 5, margin can be \>= 2.2mm)
• Signed informed consent form by the participant or their legally authorized representative (LAR)