Fractionation and total dose will depend on whether the patient has received radiation therapy in the same area previously.
If the problem is locoregional, for example a recurrence, the first attempt will be 20 fractions of 1.5 Gy, 10 fractions per week.
If the tumor responds and the patient tolerates treatment, an additional series with the same fractionation can be attempted after 14 days.
Metastases causing symptoms outside the head/neck region, such as painful bone metastases, can be treated with higher fractions, possibly 10 fractions of 3 Gy.