| Li Youmei,Li Shuguang,Song Chunyang,et al.A preliminary analysis of chemoradiotherapy combined with immunotherapy as first-line treatment for locally advanced or metastatic esophageal squamous cell carcinoma[J].Chinese Journal of Radiological Medicine and Protection,2023,43(10):766-773 |
| A preliminary analysis of chemoradiotherapy combined with immunotherapy as first-line treatment for locally advanced or metastatic esophageal squamous cell carcinoma |
| Received:February 21, 2023 |
| DOI：10.3760/cma.j.cn112271-20230221-00048 |
| KeyWords:Esophageal squamous cell carcinoma Chemoradiotherapy Immunotherapy Prognosis Failure mode |
| FundProject: |
| Author Name | Affiliation | E-mail | | Li Youmei | Radiotherapy of Department, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Li Shuguang | Radiotherapy of Department, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Song Chunyang | Radiotherapy of Department, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhao Xiaohan | Radiotherapy of Department, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Deng Wenzhao | Radiotherapy of Department, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Wen Jingyuan | Radiotherapy of Department, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Xu Jinrui | Radiotherapy of Department, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhu Shuchai | Radiotherapy of Department, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Shen Wenbin | Radiotherapy of Department, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | wbshen1979@sina.com |
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| Abstract:: |
| Objective To evaluate the efficacy and prognostic factors of radiotherapy combined with immunotherapy as the first-line treatment for patients with locally advanced or metastatic esophageal squamous cell carcinoma (LA/M ESCC). Methods A single-center, retrospective analysis was conducted for the recent efficacy, survival, prognostic factors, post-treatment failure modes, and treatment-related adverse reactions of 57 LA/M ESCC patients eligible for enrollment. Results The entire group of patients had 1-, 2-, and 3-year overall survival (OS) of 86.0%, 57.5%, and 53.9%, respectively and 1-, 2-, and 3-year progression-free survival (PFS) of 61.4%, 31.0%, and 31.0%, respectively. The median OS was not reached, and the median PFS was 15.0 (95%CI: 10.77-19.23) months. These patients had an overall response rate (ORR) of 80.7% (46/57) and a disease control rate (DCR) of 94.7% (54/57). As indicated by the result of the multivariate analysis, the independent prognostic factors affecting the OS of the patients included their age, clinical stage, number of immunotherapy cycles, and recent efficacy (HR=0.25, 2.58, 0.35, 4.05, P < 0.05), and the independent factors influencing the PFS of the patients included their clinical stage and recent efficacy (HR=2.27, 1.97, P < 0.05). There were no statistically significant differences in the effects of irradiation ranges and the combination modes of immunologic drugs and chemoradiotherapy on both OS and PFS of the patients (P > 0.05). A total of 32 patients suffered post-treatment failure. After the second treatment, they had 1- and 2-year OS of 55.7% and 25.3%, respectively, with median OS of 14.0 (95% CI: 5.17-22.83) months. A total of 26 cases experienced treatment-associated adverse reactions of grades 2 or higher during and after treatment. Conclusions The combination of radiotherapy and immunotherapy is effective and safe as the first-line treatment for LA/M ESCC patients. The post-treatment failure modes still include local recurrence and distant metastasis. Therefore, such combination merits further investigation. |
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