Abstract
Chemoradiotherapy (CRT) has become the standard of preservation treatment for head-and-neck squamous cell carcinoma. The current neck treatment policy avoids planned neck dissection and has shifted to early salvage neck dissection. The necessity of neck dissection is determined depending on the effects of CRT. Therefore, post-treatment radiological evaluation of lymph node metastases is important.
The definition of radiological CR is complete resolution of nodes or residual visualized nodes smaller than 10 mm in the axial dimension without necrotic centers, calcifications, or focal enhancement. However, radiological CR is also judged when a node with focal defect reveals no enhancement between necrosis and fibrosis, or when a node shows ring-like or complete calcification, or when focal enhancement reveals marginal crescent-shaped. We recommend a post-treatment CT scan at 4 weeks in case the clinician finds a palpable node.
