3-5 FrAction Stereotactic Body Radiation Therapy for Palliation of Head and Neck Squamous Cell Carcinoma: the FAST Phase II Randomized Trial

Inclusion Criteria: Age 18 or older Willing to provide informed consent Histologically confirmed squamous cell carcinoma Primary tumor site in the head and neck (includes oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, salivary gland, and cutaneous subsites as well as tumors of unknown primary site) Ineligible for curative intent treatment after multidisciplinary evaluation (including evaluation by radiation oncologist and surgeon followed by presentation at multidisciplinary tumor board prior to randomization) Prior therapy including radiation, surgery, or systemic therapy is permitted unless further radiation is deemed inappropriate by the enrolling physician Metastatic disease is permitted Exclusion Criteria: Contraindications to radiotherapy Pregnant or lactating women 5.0 PRE-TREATMENT EVALUATION History and physical examination including laryngopharyngoscopy by a radiation oncologist and/or head and neck surgeon within 8 weeks prior to randomization. o Clinical examination will include a detailed description of disease target including measurement where feasible to facilitate response assessment Documentation of smoking history Staging imaging within 12 weeks prior to randomization: Contrast-enhanced CT of the neck and chest or MRI of the neck with CT of the chest or Whole body PET/CT Histological confirmation of squamous cell carcinoma Pregnancy test for women of child-bearing age, within 2 weeks prior to randomization Assessment of all baseline symptoms, using CTCAE version 5.0 within 2 weeks prior to randomization. Assessment of baseline pain score (NRS) and analgesic use (non-opioid and opioid) Completion of QOL scoring within 2 weeks of randomization Informed consents must be obtained prior to any study specific activities