头颈部鳞状细胞癌（HNSCC）患者在前两年内存在显著的局部区域复发风险，大约有三分之二的患者会出现这种复发情况。尽管早期复发检测可能与病患结果的改善有关，但这种检测与生存之间的关系尚不确定。为了研究使用18F-氟脱氧葡萄糖-正电子发射计算机断层扫描（18FDG-PET/CT）进行治疗后密集随访策略与头颈部鳞状细胞癌患者生存之间的关联，我们进行了一项病例对照研究，该研究涉及法国布雷斯特（Brest）地区的3个地点的患者（大学医院，军事医院或巴斯德诊所）。统计分析从2023年1月至6月进行。研究纳入了2006年1月1日至2019年12月31日间接受治疗意愿明确的HNSCC的成人患者，这些患者在3至6个月的影像学检查中达到了完全缓解，并且具有至少3年的随访期间。接受密集随访策略的患者在首次治疗后的第12、24和36个月进行了18FDG-PET/CT检查，检查时间由耳鼻喉科医生决定。研究结果显示，进行18FDG-PET/CT检查与较低死亡风险相关（调整后的比值比为0.71；95%置信区间为0.57-0.88；P = .002），并且同时比较了年龄、性别、合并症、原发部位、分期、手术医生、治疗年份和治疗等变量。PET/CT组的平均（标准差）3年总生存率明显优于CFU组（72.5% [2.0%] vs 64.3% [2.9%]；P = .002）。根据美国癌症协会肿瘤分期，PET/CT组的III期和IV期患者（373例）与CFU组（180例）相比，3年总生存率显著增加（68.5% [2.4%] vs 55.4% [3.8%]；P < .001），而在I期或II期HNSCC患者中则没有显著差异。根据原发肿瘤部位分析显示，PET/CT组的咽峡部肿瘤患者（176例）的平均（标准差）3年总生存率较CFU组（100例）明显延长（69.9% [3.5%] vs 60.5% [5.0%]；P = .04）。这项病例对照研究发现，在标准的年度CFU流程中使用18FDG-PET/CT与HNSCC的3年生存率有关，且在初期肿瘤进展较大（III-IV期）和咽峡部疾病的患者中有更大的益处。

Patients with head and neck squamous cell carcinoma (HNSCC) have a significant risk of locoregional recurrence within the first 2 years, with approximately two-thirds of patients experiencing such recurrence. While early recurrence detection may be associated with improved patient outcomes, the association of such detection with survival remains uncertain.To investigate the association of an intensive posttreatment follow-up strategy using 18F-fludeoxyglucose-positron emission tomography with computed tomography (18FDG-PET/CT) with survival among patients with HNSCC.This case-control study was conducted among patients treated at 1 of 3 locations in Brest, France (University Hospital, Military Hospital, or Pasteur Clinic). The statistical analysis was conducted from January to June 2023. All adults with histologically proven HNSCC who were treated with curative intent between January 1, 2006, and December 31, 2019, and achieved a complete response on imaging at 3 to 6 months were included. They had a minimum of 3 years of follow-up.Patients undergoing an intensive posttreatment follow-up strategy had 18FDG-PET/CT (PET/CT group) at months 12, 24, and 36, chosen at the discretion of ear, nose, and throat surgeons.Overall survival (OS) at 3 years.Among 782 patients with HNSCC (642 males [82.1%]; median [IQR] age, 61 [56-68] years), 497 patients had 18FDG-PET/CT during follow-up and 285 patients had conventional follow-up (CFU group). Cox regression analysis showed an association between undergoing 18FDG-PET/CT and lower risk of death (odds ratio, 0.71; 95% CI, 0.57-0.88; P = .002) after adjustment for covariates (age, sex, comorbidities, primary location, stage, surgeon, year of treatment, and treatment). The mean (SD) 3-year OS was significantly better in the PET/CT vs CFU group (72.5% [2.0%] vs 64.3% [2.9%]; P = .002). Analysis based on American Joint Committee on Cancer stage showed significantly better mean (SD) 3-year OS for advanced stages III and IV in the PET/CT group (373 patients) vs CFU group (180 patients; 68.5% [2.4%] vs 55.4% [3.8%]; P < .001), while no significant difference was observed between patients with stage I or II HNSCC. Analysis based on primary tumor site revealed significantly longer mean (SD) 3-year OS for oropharyngeal tumor in the PET/CT group (176 patients) than the CFU group (100 patients; 69.9% [3.5%] vs 60.5% [5.0%]; P = .04).This case-control study found that use of 18FDG-PET/CT in the standard annual CFU of HNSCC was associated with a 3-year survival benefit, with a larger benefit for patients with advanced initial tumor stage (III-IV) and oropharyngeal disease.