| Radiation Alone: Accelerated radiation | Concurrent chemotherapy: Weekly cisplatin 40 mg/m2 for 6 cycles |
---|---|---|
Nodal status | Node negative (N0) OR Single node less than 3 cm in maximal diameter | Multiple lymph nodes OR Single lymph node more than 3 cm in maximal diameter |
Fractionation | Radiation over 5 weeks, with 6 fractions a week 6th weekly fraction given on a weekday with a minimum 6 h intrafraction interval, or on a Saturday | Daily radiation, Monday-Friday over 6 weeks |
Special conditions | In patients > 70 years of age, standard fractionation (daily, Monday-Friday over 6 weeks) can be used at the discretion of the radiation oncologist | In patients who are deemed unfit for weekly cisplatin, the dose and/or schedule can be modified, or cetuximab or weekly carboplatin AUC 1.5 can be used, at the discretion of the medical oncologist. |