While IMRT is being used at MDACC it is not being used on every oral cancer patient. The experience with this technology in brain and other cancers is fairly extensive, in oral cancer much less. In my discussions with the MDACC radiology head, they, like many other institutions are beginning to use it in a limited manner to evaluate its effectiveness in oral cancers. This means that some will get it others not. Remember that there is the whole other issue of how extensive a cancer is, and that will influence the choice as well. Obviously missing the salivary glands is beneficial to oral caner patients, but missing them, or other structures which may contain malignant cells (in too few a number to show up on the scans) would be a disservice. I had dandelions in my yard.... I started taking them out with a little trowel, and for a week or so it would look good. But then the dandelions seeds (which I could not see while I was selectively cutting the visible ones out) started to sprout and the damn things starting sprouting up in even greater numbers. Clumps even. So I got out a shovel. That seemed to do the trick... If it had spread more I would have spread the whole area with weed killer, or driven up in a backhoe to dig it all out and start again. Treatment is kind of like this. If you catch the weeds early before the go to seed, a spoon works well. If there is any doubt, you need to do something that will eradicate the bastards from the whole lawn. Bring on the big guns...