By now it is clear to me that some of the chemotherapy has roots in alchemy and black arts. MO's tend to use what they know and what has worked for them.
Frankly, there are really not many new options available, other than Erbitux. Given, that there are just a few drugs commonly used (cisplatin, carboplatin, 5FU, taxodere and the like) is is amazing how confusing this still is. Part of this is clearly dictated by the patients health etc. but a lot seems arbitrary and difficult to penetrate.

For instance you are told that either carboplatin or cisplating can be used.... and then well I am more comfortable with cisplatin. So what are you going to choose in that case?

During IMRT I will have weekly cisplatin (6 times total). After that the idea is to go to a full regimen cisplatin (3x).
The weekly dosage is roughly 1/3 rd of the dosage per shot compared to one shot if you do this 3 times only. Given the clearance rate it would seem that you get a higher bio availability if you give a lower dosage more frequenly.
I am amazed that this sort of stuff is not know, especially for a drug as ancient as cisplatin!!
Does anyone have any experience with weekly cisplatin and did anyone do this for an extended period of time in place of the regular 3x regimen?

Thanks for any insight here.