In a related editorial, the authors suggest that proponents of chemoradiation will find reasons to perpetuate its use. “First, they will note that deviations from optimal radiation technique could have compromised efficacy. However, most protocol violations were minor and adherence appears to have been more carefully monitored than in prior trials. Second, proponents will note marginally superior local control occurred in the chemoradiation group, although local control in the absence of a survival advantage does not have compelling clinical benefit. Third, advocates of chemoradiation will note that even though the study does not demonstrate superiority for chemoradiation, it also does not demonstrate superiority for chemotherapy, with near identical outcomes between treatments”.