 Although CCRT may be better than RT alone or sequential treatment, the 3 year survival in both adjuvant CCRT studies were only around 50. Is more aggressive treatment warranted? Tolerance to CCRT is a major concern. In the French study, severe acute toxicity occurred in 18 of RT only patients and 41 of patients received CCRT. In the RTOG 88-24 trial, severe and life-threatening toxicities occurred in 20 and 12 of patients, respectively; the most common drug-related toxicities were leukopenia, anemia, nausea, and vomiting . Theoretically, to optimize CCRT, continuous presence of chemotherapeutic drug or drug effect is necessary to maximize the effect of radiosensitization. For radiosensitization purpose, daily chemotherapy may be better than weekly and weekly may be better than tri-weekly. French study used weekly cisplatin with a dose of 30 mgm2. RTOG 88-24 used different treatment dose and schedule 100 mgm2 of cisplatin on radiotherapy days 1, 23 and 43. We choose weekly for convenience and hope this can increase the recruitment of patients. In the pilot study, we observed a remarkable toxicity with this treatment schedule. Considering the remarkable toxicity reported and our preliminary experience, more drugs, higher dosage, or extended schedule may not be justified. 