CORRELATION BETWEEN NODAL DENSITY IN CONTRASTED SCANS AND RESPONSE TOCISPLATIN-BASED CHEMOTHERAPY IN HEAD AND NECK SQUAMOUS-CELL CANCER - A PROSPECTIVE VALIDATION

This prospective study was done to validate an earlier retrospective s tudy demonstrating a relationship between complete response to chemoth erapy and nodal density as estimated in contrasted computed tomography (CT scans) in head and neck squamous cell carcinoma (HNSCC). CT scans of 36 patients were evaluated by two radiologists blinded to therapeu tic outcome. The density of the largest node (>2 cm) was compared to t hat of nuchal muscles. A node was classified as hypodense if more than 33% of the nodal surface area consisted of hypodense zones. Density a nd nodal staging were related: 67% (10 of 15) of patients with N3 dise ase but only 29% (six of 21) with Nl - N2 exhibited isodensity, p < 0. 05. Complete response to chemotherapy was noted in 63% (10 of 16) of t he isodense group but only in 15% (three of 20) of the hypodense group , p < 0.01. We believe that nodal density can be used for therapeutic decision-making in high nodal volume HNSCC.