Response assessment after induction chemotherapy for head and neck squamous cell carcinoma: From physical examination to modern imaging techniques and beyond

Head Neck. 2017 Nov;39(11):2329-2349. doi: 10.1002/hed.24883. Epub 2017 Aug 17.


Significant correlations between the response to induction chemotherapy and success of subsequent radiotherapy have been reported and suggest that the response to induction chemotherapy is able to predict a response to radiotherapy. Therefore, induction chemotherapy may be used to tailor the treatment plan to the individual patient with head and neck cancer: following the planned subsequent (chemo)radiation schedule, planning a radiation dose boost, or reassessing the modality of treatment (eg, upfront surgery). Findings from reported trials suggest room for improvement in clinical response assessment after induction chemotherapy, but an optimal method has yet to be identified. Historically, indices of treatment efficacy in solid tumors have been based solely on systematic assessment of tumor size. However, functional imaging (eg, fluorodeoxyglucose-positron emission tomography (FDG-PET) potentially provides an earlier indication of response to treatment than conventional imaging techniques. More advanced imaging techniques are still in an exploratory phase and are not ready for use in clinical practice.

Keywords: fluorodeoxyglucose-positron emission tomography (FDG-PET); head and neck squamous cell carcinoma; induction chemotherapy; response assessment.

Publication types

  • Review

MeSH terms

  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / pathology*
  • Diffusion Magnetic Resonance Imaging
  • Fluorodeoxyglucose F18
  • Head and Neck Neoplasms / diagnostic imaging*
  • Head and Neck Neoplasms / drug therapy
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Induction Chemotherapy*
  • Positron-Emission Tomography
  • Squamous Cell Carcinoma of Head and Neck
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Fluorodeoxyglucose F18