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a) N-stage. Patient with 47 days

between scans. Growth of lymph

node metastasis and appearance

controlateral metastasis.

b) T-stage. Patient with 19 days

between scans. Progressive bone

destruction.

Interpretation:

This study shows a negative impact of waiting time in patients with

SCCHN. Within an average time of 4 weeks the majority of the patients developed significant

signs of tumor progression.

It was not possible to define a threshold for acceptable time

intervals in order to avoid volume changes, or to define a subgroup.

impact of delay.

Radioter Oncol 2007

Effect of treatment delay