Recent studies show adjuvant concurrent chemoradiation to the emerging standard of care for high risk tumors providing an estimated five year progression free survival benefit of 11% in advanced stage III and IV tumors or even early stage tumors with extranodal spread, positive resection margins, perineural involvement or vascular embolization. A similar study by RTOG showed an estimated 10% improvement in two year locoregional control in high risk tumors with multiple lymphnodal involvement, extranodal spread and positive resection margins.