We identified 65 patients treated with definitive radiotherapy, with a median follow up of 4.33 years and 78.5% presenting with stage IV disease. Primary disease sites represented were supraglottic (n=29), glottic (n=18), hypopharyngeal (n=12), pyriform sinus (n=4), and subglottic (n=2), with 80.0% receiving ≥70 Gy RT to gross disease. A majority received either PLT (n=28, 43.1%) or CTX (n=19, 29.2%) ST, with a significant cohort (n=15, 23.1%) receiving ICI (n=9 with cisplatin, n=5 with cetuximab, n=1 as monotherapy). Total failure rate was 40.0%, with 16.9% of patients experiencing DF, 13.8% experiencing LRF, and 9.2% experiencing both LRF and DF. 86.2% of patients were alive with 80% LFS at 1 year, and 73.6% were alive with 62.4% LFS at 3 years. ST significantly impacted LFS (p=0.003) and OS (p=0.006, Figure 1), with 1-year OS of 96.4% (PLT), 68.4% (CTX), and 86.7% (ICI), and 3-year OS of 78.5% (PLT), 47.4% (CTX), and 80.0% (ICI), and LRF (p=0.026, Figure 2), with 1-year LRF of 3.6% (PLT), 36.9% (CTX), 14.4% (ICI), and 3-year LRF of 7.8% (PLT), 39.2% (CTX), and 30.0% (ICI). ST demonstrated a weak trend on DF (p=0.099).