Personalized Elective Neck Irradiation Guided by Sentinel Lymph Node Biopsy in Larynx and Pharynx Cancer. The PRIMO Study.

"Patients will undergo sentinel lymph node biopsy. Based on the histopathologic status of the sentinel lymph node(s), selective elective neck irradiation is performed with standard radiation treatment of the primary tumor.~There are 3 possible treatment scenarios.~1. Bilateral elective neck irradiation is indicated when sentinel lymph nodes at both sides of the neck contain metastases or when sentinel lymph node detection fails.~2. Unilateral elective neck irradiation is indicated when sentinel lymph node(s) at one side of the neck contain metastases.~3. Full omission of elective neck irradiation is indicated when all sentinel lymph nodes are free of metastases."

Patients randomized to the control arm will receive the standard of care, according to (inter)national clinical practice guidelines. This will consist of (chemo)radiotherapy to the primary tumor with standard elective neck irradiation in all patients. No sentinel lymph node biopsy will be performed.