3.

Treatment of locally advanced oral cancer

Staging	Patient classification 1	Patient classification 2	Level I expert recommendation	Level II expert recommendation
Patients not suitable for surgery: poor physical condition, reject opreration for various reasons, or heavy tumor burden. Patients not appropriate for cisplatin treatment: age >70 years, performance status (PS) >2, loss of hearing, renal dysfunction (creatinine clearance <50 mL/min), or > level 1 neuropathy (17).
T1−2N + T3−4 with different N	Patients who meet criteria for surgery	—	Surgery (1) (class 2A evidence)	—
	Patients who do not meet criteria for surgery	Appropriate for cisplatin treatment	Radiation therapy + cisplatin (11-13) (class 1A evidence)	Induction chemotherapy → radiation therapy alone (14-16) (class 1B evidence)
		Not appropriate for cisplatin treatment	Radiation therapy alone (1) (class 2A evidence)	—