ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m2 on Day 1
3. 5-FU 750 mg/m2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m2 on Day 1
3. 5-FU 750 mg/m2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m2 on Day 1
3. 5-FU 750 mg/m2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m2 on Day 1
3. 5-FU 750 mg/m2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m2 on Day 1
3. 5-FU 750 mg/m2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m2 on Day 1
3. 5-FU 750 mg/m2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

• nab-Paclitaxel 100 mg/m^2 on Days 1, 8, and 15
• Cisplatin 75 mg/m^2 on Day 1
• 5-FU 750 mg/m^2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

• Cisplatin 100 mg/m^2 IV on Days 1, 22, and 43
• Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
• If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m^2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m2 on Day 1
3. 5-FU 750 mg/m2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

• nab-Paclitaxel 100 mg/m^2 on Days 1, 8, and 15
• Cisplatin 75 mg/m^2 on Day 1
• 5-FU 750 mg/m^2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

• Cisplatin 100 mg/m^2 IV on Days 1, 22, and 43
• Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
• If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m^2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m2 on Day 1
3. 5-FU 750 mg/m2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m2 on Day 1
3. 5-FU 750 mg/m2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m^2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m^2 on Day 1
3. 5-FU 750 mg/m^2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m^2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m^2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m^2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m^2 on Day 1
3. 5-FU 750 mg/m^2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m^2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m^2 IV week for 8 weeks

ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)

1. nab-Paclitaxel 100 mg/m^2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m^2 on Day 1
3. 5-FU 750 mg/m^2 on Days 1-3

If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.

Definitive Therapy

1. Cisplatin 100 mg/m^2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m^2 IV week for 8 weeks