3-year overall survival benefit of systematic follow-up with 18F-FDG PET/CT in asymptomatic patients treated for head and neck squamous cell carcinoma: a multicenter study

IF 7.6 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Journal of Nuclear Medicine and Molecular Imaging Pub Date : 2025-02-26 DOI:10.1007/s00259-025-07147-9

C. Mahéo, R. Abgral, C. Clément, O. Malard, F. Espitalier, C. Ferron, O. Delcroix, R. Le Pennec, U. Schick, V. Tissot, G. Le Gal, F. Kraeber-Bodéré, T. Eugène, R. Marianowski-, P. Y. Salaün, Jean-Christophe Leclère-

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Abstract

Purpose

Patients diagnosed with head and neck squamous cell carcinoma (HNSCC) face a significant risk of locoregional recurrence within the first two years after treatment. While early detection of recurrence could potentially improve patient outcomes, the impact of such detection on survival remains uncertain. The aim was to assess the potential benefit of a systematic post-treatment follow-up strategy using 18 F-FDG PET/CT imaging on overall survival.

Methods

In this multicenter case-control study, patients were treated in two health areas from two different regions in France. All adults diagnosed with histologically confirmed HNSCC and treated between January 2017 and December 2020 with curative intent, with a complete response on imaging were included in the study. Primary endpoint was 3-year overall survival. The log-rank test was used to compare 3-year OS rates between the CFU (conventional follow-up) and PET/CT groups. A Cox regression model was used to assess the effect of the addition of 18 F-FDG PET/CT on survival outcomes.

Results

A total of 697 patients were included (534 males [77%], median age[IQR] 62[57–69] years); 508 patients had CFU and 189 patients had CFU + systematic annual 18 F-FDG PET/CT. Cox regression analysis showed a protective effect (OR = 0.56, 95%CI:0.397–0.795, p = 0.001) of systematic 18 F-FDG PET/CT. The 3-year OS in the PET/CT group was better than in the CFU group (83.5 ± 2.8% vs. 73.4 ± 2.1%, p = 0.008). The analysis based on stage showed a significantly better 3-year OS for advanced stage III/IV in the PET/CT group (n = 124) than in the CFU group (n = 312)(79.9 ± 3.7% vs. 71.5 ± 2.7%, p = 0.045) as well as for early stage I/II (90.5 ± 3.7% vs. 76.3 ± 3.2%, p = 0.047).

Conclusion

In this multicenter study, the use of 18 F-FDG PET/CT as an alternative to annual chest CT in the follow-up of head and neck squamous cell carcinoma (HNSCC) is associated to a survival benefit at 3 years.

Clinical trial number

Not applicable (retrospective study).

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18F-FDG PET/CT系统随访治疗无症状头颈部鳞状细胞癌患者的3年总生存获益：一项多中心研究

目的头颈部鳞状细胞癌（HNSCC）患者在治疗后的头两年内面临显著的局部复发风险。虽然早期发现复发可能会改善患者的预后，但这种发现对生存率的影响仍不确定。目的是评估使用18f - fdg PET/CT成像系统的治疗后随访策略对总生存期的潜在益处。方法在这项多中心病例对照研究中，患者在法国两个不同地区的两个卫生部门接受治疗。所有在2017年1月至2020年12月期间被诊断为组织学证实的HNSCC并接受治疗且影像学完全缓解的成年人都被纳入该研究。主要终点为3年总生存期。采用log-rank检验比较CFU（常规随访）组和PET/CT组的3年OS率。采用Cox回归模型评估添加18 F-FDG PET/CT对生存结局的影响。结果共纳入697例患者，其中男性534例[77%]，中位年龄[IQR] 62[57 ~ 69]岁；CFU 508例，CFU +系统年度18 F-FDG PET/CT 189例。Cox回归分析显示系统18 F-FDG PET/CT具有保护作用（OR = 0.56, 95%CI: 0.397-0.795, p = 0.001）。PET/CT组3年OS优于CFU组（83.5±2.8%比73.4±2.1%,p = 0.008）。基于分期的分析显示，晚期III/IV期PET/CT组（n = 124）的3年OS明显优于CFU组（n = 312）（79.9±3.7% vs. 71.5±2.7%,p = 0.045）和早期I/II期（90.5±3.7% vs. 76.3±3.2%,p = 0.047）。结论：在这项多中心研究中，在头颈部鳞状细胞癌（HNSCC）的随访中，使用18f - fdg PET/CT作为年度胸部CT的替代方案与3年生存率相关。临床试验编号不适用（回顾性研究）。

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来源期刊

European Journal of Nuclear Medicine and Molecular Imaging 医学-核医学

CiteScore

15.60

自引率

9.90%

发文量

392

审稿时长

3 months

期刊介绍： The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.