You are rightly confused. There are guidelines established for different levels of disease by a large group of comprehensive cancer centers. Many hospitals outside these centers have their own protocols, and then you have the constantly changing research results that are tossed into the mix almost weekly. All this yeild different treatments for different people.

Since there is node involvement, radiation, likely in the form of IMRT is probably in the cards for your father. The best results show radiation being used with concurrent chemo, different drugs based on where you are being treated, and further, whether they qualify as a clinical trial site. Just using one example MDACC, at recent tumor boards there for patients with similar disease states to what you describe, show them leaning towards radiation and chemo first with selective neck dissections done afterwards. But were you at another institution you might get a very different plan. When it comes to treatments, they are as individual as the patients. Your profile only says USA and you do not mention where he is being treated. Once associated with a major ccc, and having gone through a proper tumor board, with complete work ups including scans for distant mets, I would be inclined to follow their recommendations. When you approach a group as geographically diverse as those here, and from treatment facilities including private smaller community hospitals to the biggest ccc's, you will get a variety of opinions, none which are absolutes. Here is the link to the page on the OCF website that has the NCCN guidelines for treatment as of 2006. http://www.oralcancerfoundation.org/treatment/guidelines.htm