Cancer types
Title of study
Uniform FDG-PET guided GRAdient Dose prEscription to reduce late Radiation Toxicity (UPGRADE-RT): a randomised controlled trial with dose reduction to the elective neck in head and neck squamous cell carcinoma
Version Number
Approval Date 
3.4, 24 July 2017
Short Title
Upgrade RT
Study site
Principle Investigator
Prof. Dr. J.H.A.M. Kaanders
Investigator Maastro
F. Hoebers
Radboud University Medical Center
Trial registry

To investigate the toxicity, safety and quality of life after treatment with dose reduction to elective lymph node regions and intermediate risk lymph nodes identified by 18F-FDG-PET-scan

Primary Endpoint 

To evaluate the morbidity (acute and late toxicity) and quality of life after radiation treatment with dose reduction. Dose reduction to elective lymph node regions is expected to result in a lower dose to organs at risk during radiotherapy, such as the salivary glands, swallowing structures and the thyroid gland. As a result quality of life is expected to increase after treatment

Secondary Endpoints 

To evaluate the safety of such a treatment strategy since dose reduction can lead to a potentially, albeit small, increased risk of recurrence in electively irradiated lymph nodes