ChatGPT versus DeepSeek in head and neck cancer staging and treatment planning: guideline-based study.

Purpose: This prospective simulation study was conducted to evaluate and compare the performance of ChatGPT (o1, 2023) and DeepSeek (V3, 2024) in staging and treatment planning for head and neck cancers.

Methods: This prospective simulation study was conducted in March 2025 to evaluate and compare the performance of two advanced artificial intelligence (AI) models, ChatGPT (o1, 2023) and DeepSeek (V3, 2024), in clinical decision-making for head and neck malignancies. A total of 50 hypothetical, guideline-based clinical scenarios were carefully designed in English by two otorhinolaryngologists in alignment with the National Comprehensive Cancer Network® (NCCN®) Guidelines Version 2.2025.

Results: In the overall analysis of treatment planning performance, DeepSeek (V3, 2024) demonstrated statistically superior accuracy compared to ChatGPT (o1, 2023) (p = 0.04). Both models showed comparable performance in tumor staging (p = 0.83). Both DeepSeek (p = 0.0001) and ChatGPT (p = 0.02) were statistically successful in respect of staging accuracy and providing fully correct answers on the subject of treatment.

Conclusion: Although DeepSeek V3 demonstrated promising capability for clinical decision support in head and neck oncology, these artificial intelligence tools cannot replace multidisciplinary tumor boards. However, they can significantly streamline clinical workflows by rapidly organizing patient data, thereby enhancing board efficiency. Future efforts should prioritize the development and integration of secure, institution-specific, local large language models tailored for oncological decision-making.