Some here have had radiation and chemo only for treatment of tongue cancer. So I am not surprised that MSKCCC is recommending radiation only. It seems logical what the RO at Fox Chase told you as well about radiation not making up for inadequate surgery. But what it boils down to is that you have to decide which weapons to use in your fight - not an easy call -and no easy choices.

The good news is that this really isn't a recurrence, just margins that are too close.
Have they in fact determined that you have lymph node involvement? Or is the radical neck disection precautionary?

If it were me and I had tongue cancer I would probably be going with all three, knowing how aggressive tongue cancers can be. But since you have already had surgery, would the radiation and chemo be enough to clean things up? They can always target various lymph nodes with radiation like they did to me as well.

If you read through the oncology practice guidelines there are always some areas where the experts disagree. You will have to go with your gut here.

To Deni:
Post radiation treatment is usually in the form of "salvage" surgery. In some cases radiation may be repeated, if it was IMRT or if the "boost" wasn't administered the first time. Chemo is still not the panacea for H&N cancers.
If you are not getting treatment at a comprehensive cancer center, then I would find one and have them review your file and get a second opinion. By the time recurrences are discovered thousands more cancer cells have been put in the bloodstream increasing the risk of distant metastesis. It is far better to kill the cancer the first time.