Work

Survival Benefit of Combined Chemoimmunotherapy and Radiation Therapy in Patients with Recurrent or Metastatic Esophageal Cancer

Year: 2025

Type: article

Abstract: Background and purpose : Chemotherapy combined with immune checkpoint inhibitors (ICIs) has become the standard first-line treatment for recurrent or metastatic esophageal cancer, but its efficacy remains suboptimal. This study aimed to evaluate whether the addition of radiotherapy (RT) to ICIs can improve patients' survival. Materials and methods : This retrospective cohort study analyzed clinical data from 178 patients with recurrent or metastatic esophageal cancer who were treated at XXXX Hospital between December 2019 and October 2023. Based on their actual treatment regimens, patients were stratified into two groups: the chemoimmunotherapy-alone group (ICIs group) and the chemoimmunotherapy combined with radiotherapy group (ICIs + RT group). To minimize selection bias, propensity score matching (PSM) was used to balance baseline characteristics between the groups before comparative analysis. The primary end point was overall survival (OS), and the secondary end points were progression-free survival (PFS) and safety. Results : After PSM, 128 patients were selected for the final analysis, with 64 patients in the ICIs + RT group and 64 patients in the ICIs group. The median follow-up time was 11.26 months (95% confidence interval (CI), 7.02–15.32). The median OS was 23.71 months in the ICIs + RT group and 13.00 months in the ICIs group (hazard ratio [HR], 0.53; 95% CI, 0.31–0.88; P = 0.013). The median PFS was 10.43 months in the ICIs + RT group and 7.27 months in the ICIs group (HR, 0.61; 95% CI, 0.39–0.94; P = 0.024). Combination of chemoimmunotherapy and radiotherapy was safe and tolerable. No treatment-related deaths occurred in either group. Conclusion : Adding radiotherapy can significantly improve survival in patients with recurrent or metastatic esophageal cancer who are treated with chemoimmunotherapy, but further prospective trials are needed for validation.

Source: Advances in Radiation Oncology

DOI: 10.1016/j.adro.2025.101890