Platinum-based CCRT, as a standard form of treatment in LA-SCCHN, is hampered by toxic effects.

Knowledge gaps exist in criteria for platinum unsuitability with LA SCCHN.

We try to identify patients who are ineligible for platinum based therapy or at high risk of severe toxicities.

Age, co-morbidity and organ dysfunctions are the most important factors that need to be considered.

Alternative options are available; but there has been no sufficient evidence to support these approaches in reaching the same level of recommendation.