This is a controversial area with varied opinions. Here are a few of my takeaways:  For delayed patients especially with high risk pathology, I usually re-image (preferably with PET) before making a recommendation. This is based on multiple series (Shintani et al., PMID 17889447, Kibe et al., ...

In this patient, the literature suggests that the risk of LR recurrence is reduced by adjuvant therapy if delivered on time, however, treatment has been delayed by significantly more than  6-8 weeks. Assuming no evidence of recurrence at that time, 1. The risk of recurrence in this patient is l...

We feel comfortable offering adjuvant radiation within 3 months of surgery and would not accelerate the treatment which would add considerable toxicity in the post-operative setting. Beyond 6 months from surgery, I would favor restaging imaging and observation if there is no evidence of disease. Dat...

I agree with @Avraham Eisbruch on this point. Patients who are offered adjuvant radiation therapy post-op are often those with high-risk features such as close or positive margins, multiple positive nodes, extracapsular extension, or a combination thereof. The literature for the efficacy of adjuvant...

I agree with up to 12 weeks postop. Just because postop trials were <=8 weeks does not mean that 8-12 weeks is not effective. I have seen multiple postop patients over the years followed who then develop recurrence about 9-12 months after initial surgery. Locoregional control is unquestionably be...

I feel the treatment "package time" is meaningful primarily in oral cavity cancers, especially in those with high-risk features (positive margin, ENE, or large tumor with multiple other risk features), not so much in other HNCs. In my own experience, early recurrences after surgery are mostly seen i...