Because of accessibility and the risk of involvement of bony struc- tures, treatment with radiotherapy can lead to radionecrosis of the mandible or maxilla. Moreover, oral cavity squamous cell carcino- mas may be less sensitive to chemotherapy and radiation, relative to oropharyngeal or laryngeal cancers. Thus, primary treatment for most tumors is surgical. Positive surgical margins, multiple involved lymph nodes, and/or extracapsular tumor extension call for consid- eration of postoperative chemoradiotherapy, to improve local dis- ease control