The NCCN guidelines for treating oral cancer is a good place to check to see when concurrent chemo is recommended--and they have changed soemwhat on this in the last year I think.

http://www.nccn.org/professionals/physician_gls/PDF/head-and-neck.pdf

According to the now-guidelines, I really didn't need chemo. But when I got a second opinion at Dana Farber, they recommended chemo with the radiation, even though I was stage II and had clean margins (they weren't sure I did after the first surgery but in the second one he took more tissue and it was cancer free so I think that really means I had clean margins all along--just not enough tissue wsa removed in one spot to tell the first time around). The medical oncologist there admitted this was a more aggressive recommendation, but there were some other risk factors associated with my tumor and eventually I came to see it his way--if there was a chance it could help the radiation be more effective, why not?

The two really big research papers on concurrent chemo do show a 10-15% improvement in local control, as Gail said, but the majority of research participants in those studies (all of them in one study) were stage 3 or 4. My medical oncologist said that a good rule of thumb is that since stage 2 folks in general have 1/2 the likelihood of local recurrence of the more advanced stages, you can estimate the chemo would prduce half the benefit. That's still a 5-8 % improvement in local control, which sounded like it was worth it to me. But again, that's kind of a loose estimate, not based on clear data.

Nelie