Prognostic analysis of first-recurrence/metastasis esophageal squamous cell carcinoma: chemoimmunotherapy combined with radiotherapy as one of the optimal clinical management strategies.

Authors

Yitong Li, Qiaofang Li, Kuo Wang, Mengchang Gao, Lei Tian, Miaomiao Liu, Yuqing Bu, Yujie Cui

Published in

Frontiers in immunology. Volume 17. Pages 1791354. Epub Jul 21, 2026.

Abstract

The real-world efficacy and prognostic factors of First-line and subsequent-line treatment for first-recurrent/metastatic esophageal squamous cell cancer (ESCC) have not been fully evaluated.
This single-institutional retrospective cohort study evaluated 156 first-recurrent/metastatic ESCC patients treated with First-line and subsequent-line treatment between January 2018 to January 2023. We assessed tumor response, long-term survival, and prognostic factors.
Among 156 ESCC patients with measurable lesions, in the first-line treatment setting, the combined Immunotherapy+Radiotherapy+Chemotherapy (IT+RT+CT) group had a lower incidence of progressive disease (PD) and Death compared with the Chemotherapy+Immunotherapy (CT+IT) group (80.0% vs 90.6%). First-Line Treatment were independent factors that affect progression-free survival (PFS), better PFS in the IT+RT+CT group compared to the CT+IT group (HR: 0.50, 95%CI: 0.28-0.90, P = 0.020). In the First-line and subsequent-line treatments, IT+RT+CT were identified as significant prognostic factors of overall survival (OS) through Cox proportional hazards analysis. After inverse probability of treatment weighting (IPTW) between the IT+RT+CT group and the CT+IT group in the First-line and Subsequent-line Treatments, the 1-, 2-year OS were 76.2% and 46.5% in the IT+RT+CT group, and 1-, 2-year OS were 39.5% and 19.4% in the CT+IT group, respectively (P = 0.011). In the doubly robust Cox proportional hazards model, which incorporated IPTW with weight trimming and adjustment for residual confounders (SMD>0.1), in the First-line and Subsequent-line Treatments, the IT+RT+CT regimen was significantly associated with improved OS compared to the CT+IT regimen (HR: 0.48, 95%CI: 0.27-0.85, P = 0.011).
Our study demonstrated that, IT+RT+CT as first-line treatment for recurrent/metastatic ESCC significantly prolonged PFS compared to CT+IT. Furthermore, IT+RT+CT extended OS in First-line and subsequent-line treatments. However, these findings require validation in prospective studies to confirm their clinical significance.

PMID:
42553314
Bibliographic data and abstract were imported from PubMed on 05 Aug 2026.

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