Phase II Randomized-registry Embedded Study of Lymphoscintigraphy for Oropharyngeal Neoplasms to Enable Risk-adapted Nodal Guidance for Robotic Surgery and/or Radiotherapy (LONE-RANGR2)

This study is testing a specialized imaging technique called lymphoscintigraphy — which maps nearby lymph nodes — to guide more precise surgery and radiation treatment for early-stage throat cancers linked to HPV. The goal is to treat only the lymph nodes that actually need treatment, reducing side effects. **You may be eligible if...** - You have a newly diagnosed HPV-positive cancer at the base of the tongue or tonsil - Your cancer is early stage (T1-T2, N0-N1) and does not cross the midline of your throat - You are over 18 years old - You have no signs of cancer spread to the far side of your neck or to distant organs - You have not yet received chemotherapy or surgery for this cancer **You may NOT be eligible if...** - You have previously had head or neck cancer (other than small skin cancers) - You have had prior radiation to the head and neck area - You have cancer that has spread to distant parts of the body - You are pregnant or not using effective contraception - You have a known allergy to iodine or the injection agent used in the imaging - You have active scleroderma, lupus, or similar autoimmune disease that would make radiation unsafe Talk to your doctor to see if this trial is right for you.