Palliative Steroeotactic Body Radiotherapy vs Palliative Standard Radiotherapy in Patients With Advanced Head and Neck Cancer

This study is being done to answer the following question: Does stereotactic body radiation therapy (SBRT) provide better cancer control compared to standard radiation therapy (RT) for those with advanced head and neck cancer?

Inclusion Criteria: * Histologically confirmed mucosal squamous cell carcinoma (SCC) of the head and neck arising from at least one of the following sites: oro/hypopharynx, oral cavity, supraglottic larynx, maxillary sinus, nasal cavity, or unknown primary * Stages TX or T0-T4/N0-N3 * Must be considered unfit for curative intent RT as determined by the treating oncologist(s) * Geriatric 8 score \8 cm (in one dimension). * \> 2 nodal levels (Level 1a/b not counted); retropharyngeal lymph nodes (where the closest edge is \< 2cm from the closest edge of CTV (primary or nodal) will not be considered as a different level). Note: a single lymph node mass that spans 2 levels will be considered as 1 level. * Gross tumour poorly visualized on CT/MRI. * Definitive radiological or clinically evident distant metastases. * Scleroderma/CREST syndrome.