case_images: PMC11127563_01
case_images: (A) MRI of the nasopharynx and lymph node before treatment (July, 2022). (B) MRI of the nasopharynx and lymph node after 2 two cycles of GPchemotherapy regimen (August, 2022). (C) CT of the lymph node after loading dose of toripalimab along with cetuximab (August, 2022). (D) MRI of the nasopharynx and lymph node after radiotherapy (October, 2022). (E) MRI of the nasopharynx and lymph node performed 2 months after the completion of radiotherapy (December, 2022).
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case_images: Magnetic resonance imaging (MRI) of the nasopharynx and neck examination revealed the presence of nasopharyngeal lesions and enlarged bilateral cervical lymph nodes (level II,III,IV,V on the right and level II on the left) fused into masses, with the maximum dimension measuring 11.4cm in the coronal plane ( Figure 1A ). Subsequent MRI scan indicated a size reduction in the nasopharyngeal lesions but an enlargement in the cervical lymph nodes ( Figure 1B ). Subsequent CT scans showed a slight reduction in tumor size ( Figure 1C ). Post-treatment MRI scans suggested partial remission (PR) ( Figure 1D ). After radiotherapy, the patient continued toripalimab (240mg every 3 weeks) along with cetuximab (250 mg/m2 every week) until 2 months later when the MRI of nasopharynx and neck examination indicated CR ( Figure 1E ).
case_images: Due to the rapid reduction in the size of cervical lymphnodes, adjustment to the radiotherapy plan were made every two weeks. (A) The beam arrangement and isodose distribution at the beginning of radiotherapy. (B) The beam arrangement and isodose distribution in the third week of radiotherapy. (C) The beam arrangement and isodose distribution in the fifth week of radiotherapy.
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case_images: Notably, due to the rapid reduction in cervical lymph node size, adjustments to the radiotherapy plan were made every two weeks ( Figure 2 ).
case_images: The time line of interventions and patient outcomes.
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case_images: The timeline depicting interventions and outcomes of the case is illustrated in  Figure 3 .