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Background To assess the role of diffusion weighted imaging (DWI) in predicting progression-free survival in patients with squamous cell carcinomas of head and neck (HNSCC) treated with induction chemotherapy. Methods Eighteen patients with HNSCC underwent DWI studies prior to treatment and within 3-weeks after completion of induction chemotherapy. Median apparent diffusion coefficient (ADC) values were computed from the largest cervical metastatic lymph node. Percentage (%) changes in ADC values from pre-treatment to post-treatment time points were compared between alive and dead patients using Mann-Whitney test. Probability (p) value of less-than 0.05 was considered significant. Results A 22% increase in ADC was observed after induction chemotherapy in alive patients (n=15), while patients who died from HNSCC (n=3) demonstrated a 33% decrease in ADC. The difference in % change in ADC between alive and dead patients was significant (p=0.039). Conclusions ADC may be a useful marker in predicting progression-free survival in HNSCC patients undergoing induction chemotherapy.

This is the largest single-center study conducted to investigate the frequency and the management strategies in patients with CHR who were treated with the same chemotherapy protocol for LGG. Premedication and desensitization were the preferred modifications in case of CHR. Overall, the success rate for carboplatin continuation is high in comparison to previous studies. Carboplatin can be continued successfully in many cases with CHR if reactions are managed in a timely fashion.