| Feng Peixin,Hou Qing,Yao Ningning,et al.Survival advantage of first-line chemoimmunotherapy combined with radiotherapy for advanced esophageal squamous cell carcinoma: A propensity score matching analysis[J].Chinese Journal of Radiological Medicine and Protection,2025,45(8):766-773 |
| Survival advantage of first-line chemoimmunotherapy combined with radiotherapy for advanced esophageal squamous cell carcinoma: A propensity score matching analysis |
| Received:November 26, 2024 |
| DOI：10.3760/cma.j.cn112271-20241126-00457 |
| KeyWords:Esophageal cancer Immunotherapy Radiotherapy Propensity score matching |
| FundProject:山西省肿瘤医院国家肿瘤区域医疗中心科教培育基金,团队基金(TD2023002,SD2023017,SD2023022);山西省医学重点科研项目计划(2022XM32);山西省回国留学人员科研资助项目(2022-210);山西省基础研究计划项目(202303021221239);山西省卫生健康委课题(2022128) |
| Author Name | Affiliation | E-mail | | Feng Peixin | Department of Radiotherapy, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Hou Qing | Department of Radiotherapy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Yao Ningning | Department of Radiotherapy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Zhang Wenjuan | Department of Radiotherapy, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Sun Bochen | Department of Radiotherapy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Niu Wenxia | Department of Radiotherapy, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Zhao Anqi | Department of Radiotherapy, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Chen Wenlu | Department of Radiotherapy, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Wu Baixue | Department of Radiotherapy, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Zhou Yuying | Department of Radiotherapy, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Zhang Yiwen | Department of Radiotherapy, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Liang Yu | Department of Radiotherapy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Cao Xin | Department of Radiotherapy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Bai Wei | Department of Radiotherapy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Liu Jianting | Department of Radiotherapy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Zhang Shuangping | Department of Radiotherapy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | | | Cao Jianzhong | Department of Radiotherapy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China | caojianzhong@sxmu.edu.cn |
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| Abstract:: |
| Objective To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy. Methods A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy (n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95%CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy. |
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