Inclusion Criteria:

- Histologically confirmed diagnosis of head and neck carcinoma (excluding nasopharynx,
paranasal sinus, salivary, and thyroid malignancies)Any unknown primary squamous cell
carcinoma of head and neck with gross nodes is allowed (2002 AJCC)

- 18 years of age or older

- Must not have received prior radiation therapy or chemotherapy for this diagnosis.
Patients who have had their primary site tumor removed by surgery but still present
with grossly enlarged lymph nodes are eligible for this study.

- Karnofsky performance status ≥ 70.

Exclusion Criteria:

- all nasopharyngeal, paranasal sinus, salivary cancer, and thyroid malignancies

- prior chemotherapy or radiotherapy within the last three years

- patients that underwent surgical resection for the same disease (except for biopsy or
surgery removing primary site tumor but still present with grossly enlarged lymph
nodes)

- any prior radiotherapy to the head and neck region

- pregnant (confirmed by serum b-HCG in women of reproductive age) or breast feeding