It is really difficult to talk specifics about one person's treatment. Each cancer and each individual is so unique that there are only generalities that we can say about appropriate treatments. So in general, chemo is usually reserved for those with more advanced stages of oral cancer where the risk of a distant metastasis is more likely. Hence a "systemic" treatment like chemotherapy, that is not isolated to the mouth. This cancer reoccurs at an extremely high rate. That rate does not appear to be tied to, or affected, by which different treatment modality was used. I too was offered a round of chemo after radiation and surgery, but I was just too physically and mentally beat up at that point in time, and I chose not to have a "wash" of chemo to possibly pick up a micro metastasis at a distant site, that might grow and prosper over the course of a few years. At 4 years out now, it still remains to be seen if that was the right choice. There is a higher percentage of recurrences in the first five years than later, though they still happen to people many more years out. There is no guarantee that if she had chemo, that she would not have had this recurrence. It happens to people regardless of the treatment protocols, including those that have had chemo.