In the setting of adjuvant treatment for locally advanced oral cavity cancer, would you offer altered/hypofractionated courses for elderly patients with lower functional status?

At our institution, elderly patients with locally advanced oral cavity cancers who are treated with curative intent oncological resection are typically also treated with curative intent conventionally fractionated adjuvant radiation based on pathological risk factors. For elderly patients with lower functional status, we prioritize the upfront multidisciplinary discussion of the entire treatment package before commencing with any therapy. These patients are seen by radiation oncology prior to resection so they understand the standard of care postop radiation prescription (typically 60-66 Gy at 2 Gy/fx). The overwhelming majority of such cases at our institution are treated with surgery and conventionally fractionated radiation if postoperat...

It would depend on how debilitated and how high risk (positive margins, ENE, etc.).