Would you add concurrent chemotherapy to definitive radiation based on suspicion for extranodal extension (ECE/ENE) on imaging (adjacent fat stranding) for a clinical T1-2N1 (single node < 3cm) oropharyngeal cancer?  

If no, would your recommendation change if there is obvious extranodal extension with invasion of adjacent muscle?  Does p16 status affect your decision?  



Answer from: Radiation Oncologist at Academic Institution