Docetaxel and Radiation Therapy in Treating Patients with HPV Positive Oropharynx Cancer

Inclusion Criteria

• PRE-REGISTRATION (OPTIONAL)
• Provide written informed consent
• Submission of research blood draw and/or tumor sample
• REGISTRATION
• Histological confirmation of human papillomavirus (HPV) positive (+) squamous cell carcinoma of the oropharynx; HPV positivity will be defined as positive staining for p16 on immunohistochemistry (IHC)
• Gross total surgical resection with curative intent of the primary tumor and at least unilateral neck dissection within 7 weeks of registration
• Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1
• Absence of distant metastases on standard diagnostic work-up =< 16 weeks prior to registration; (chest computed tomography [CT], chest x-ray [CXR], or positron emission tomography [PET]/CT)
• Must have one of the following risk factors: * Lymph node > 3 cm * 2 or more positive lymph nodes * Perineural invasion * Lymphovascular space invasion * T3 or primary disease * Lymph node extracapsular extension
• Absolute neutrophil count (ANC) >= 1500/mm^3 (obtained =< 35 days prior to registration)
• Platelet count >= 100,000/mm^3 (obtained =< 35 days prior to registration)
• Hemoglobin >= 8.0g/dL (obtained =< 35 days prior to registration)
• Creatinine =< 1.5 mg/dL or creatinine clearance >= 50 mL/min (obtained =< 35 days prior to registration)
• Total or direct bilirubin < 2 x institutional upper limit of normal (ULN) (obtained =< 35 days prior to registration)
• Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) or alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) < 3 x institutional (obtained =< 35 days prior to registration)
• Negative pregnancy test done =< 7 days prior to registration, for women of childbearing potential only
• Ability to complete questionnaire(s) by themselves or with assistance
• Provide informed written consent
• Willingness to return to enrolling institution for follow-up (during the active monitoring phase of the study)

Exclusion Criteria

• Any of the following: * Pregnant women * Nursing women * Men or women of childbearing potential who are unwilling to employ adequate contraception
• Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens
• Immunocompromised patients and patients known to be human immunodeficiency virus (HIV) positive
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm
• Other active malignancy =< 5 years prior to registration; EXCEPTIONS: non-melanotic skin cancer or carcinoma-in-situ of the cervix; NOTE: if there is a history or prior malignancy, they must not be receiving other specific treatment for their cancer
• Prior history of radiation therapy to the affected site
• History of connective tissue disorders such as rheumatoid arthritis, lupus, or Sjogren’s disease
• Presence of any of the following risk factors after surgery: * Any positive surgical margin. * Adenopathy below the clavicles
• Prior systemic chemotherapy
• History of allergic reaction to docetaxel
• Receiving any medications or substances which in the opinion of the investigators would interfere with treatment; examples could include strong inhibitors of CYP3A4 at oncologist discretion
• Severe pre-existing ototoxicity or neuropathy that would, in the opinion of the investigator, preclude the use of cisplatin chemotherapy
• If there are 3 or more attempts by the surgeon to clear margins, patient is not eligible for study
• T4 tumors are excluded