How do you manage patients with persistent/recurrent disease in the neck >6 months after receiving definitive chemo-RT for p16-negative oropharyngeal SCC?  

Does your approach differ from p16 positive disease?

Assuming a biopsy shows active disease and the metastatic workup is negative, when would you offer re-irradiation, either alone or after neck dissection?

Which radiation modalities, dose, and fractionation do you typically employ?

When is systemic therapy preferred?