Adaptive Radiotherapy for Head and Neck Cancer

• Adaptive Radiotherapy (Radiation), also known as ART: ART involved modification of the radiation treatment plan during treatment course to account for temporal variations in anatomy due to changes in tumor volume and/or patients' weight loss.

Primary outcomes

• Number of patients with locoregional recurrence-free interval [2 years]: This is assessed by imaging studies and/or physical exams at follow- up visits. This will include a diagnostic FDG PET/CT scan. CT and/or MRI of the primary site and neck will also be recommended. Patients will be classified as locoregional recurrence-free as long as there is no evidence of locoregional recurrence of disease by clinical evaluation, CT, MRI, and/or PET-CT according to the standard of care. For patients achieving complete response of disease, no further imaging study is necessary.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Participants with pathologically confirmed cancers of paranasal sinuses, oropharynx, oral cavity, nasopharynx, larynx, hypopharynx, and unknown primary and will receive definitive radiation therapy with or without chemotherapy.
* Karnofsky performance status >= 70%
* Women of childbearing potential need to have a negative serum pregnancy test at the time of therapy
* Participants must have the ability to understand and the willingness to sign a written consent form

Exclusion Criteria:

* Female participants who are pregnant or breast feeding
* Participants who are not able to comply with study and/or follow up procedures
* Participants who have received induction chemotherapy before radiation treatment
* Participants who had prior head and neck radiation therapy
* Participants who are enrolled in a national/international cooperative group trials
* Patients with metastatic disease

• C. Jillian Tsai, MD, Principal investigator, Memorial Sloan Kettering Cancer Center