Phase II Randomized-registry Embedded Study of Lymphoscintigraphy for Oropharyngeal Neoplasms to Enable Risk-adapted Nodal Guidance for Robotic Surgery and/or Radiotherapy (LONE-RANGR2)

Exclusion Criteria

• •Previous HN Cancer except small skin cancers.
• •Any retropharyngeal lymphadenopathy on either MRI, CT, or PET/CT
• •Contralateral neck nodal disease radiographically detected per routine diagnostic imaging or SPECT-CT.
• •Distant metastatic spread at the time of inclusion
• •Chemotherapy or surgery (for the present tumor), prior to inclusion.
• •Previous radiation treatment in the head and neck region, for any reason, except for cutaneous lesions that would not lead to overlap with definitive bilateral neck irradiation
• •Recurrent or second primary tumor in the head and neck region
• •Non-tongue base or non-faucial tonsil primaries
• •Prior history of regionally advanced or distant spread cancers
• •Pregnancy or no active contraception for pre-menopausal women
• •Known hypersensitivity to iodine or nanocolloid injection
• •Having any condition (physical, mental, sociological) that interferes with the informed consent procedure and follow-up schedules Has a diagnosis of active scleroderma, lupus, or other rheumatologic disease which in the opinion of the treating radiation oncologist precludes safe radiation therapy