Dose Escalation Using Hypoxia-adjusted Radiotherapy

This study is testing whether adjusting the dose of radiation therapy based on how much oxygen is in a tumor (a technique called hypoxia-guided radiotherapy) can improve outcomes for people with head and neck squamous cell cancer. Tumors with low oxygen levels are often harder to treat with standard radiation. **You may be eligible if...** - You are between 18 and 70 years old - You have been diagnosed with squamous cell carcinoma of the mouth, throat, voice box, or hypopharynx, confirmed by biopsy - You are in acceptable physical condition (ECOG 0–2) - Your blood counts and organ function are within acceptable limits - You have completed dental and nutritional assessments before starting **You may NOT be eligible if...** - Your tumor tests positive for HPV (p16-positive) - You have had prior surgery or radiation for head and neck cancer - You have early-stage voice box (glottis) cancer (T1/T2) - Your cancer has spread to distant organs - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.