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May 13, 2026Open Access

Efficacy and safety of concurrent chemoradiotherapy combined with immunotherapy for locally advanced esophageal squamous cell carcinoma: a retrospective cohort study

Key Points

This study aims to evaluate the efficacy and safety of concurrent chemoradiotherapy combined with immunotherapy in patients with locally advanced unresectable ESCC.
Retrospective cohort design involving 106 patients at Guangxi Medical University from July 2019 to December 2022.
Comparison of treatment outcomes between 60 patients receiving CCRT + IT and 46 patients receiving CCRT only.
Analysis of objective response rates, progression-free survival, overall survival, and adverse events.
CCRT + IT group had a significantly higher objective response rate (76.7% vs. 52.2%; p = 0.008).
1-year progression-free survival was better in the CCRT + IT group (66.7% vs. 41.3%; p = 0.009).
1-year overall survival was also higher in the CCRT + IT group (80.0% vs. 58.7%; p = 0.017).

Abstract

Concurrent chemoradiotherapy (CCRT) is the standard treatment for unresectable esophageal squamous cell carcinoma (ESCC). However, its local control rate and overall survival (OS) gain are limited, resulting in a 5-year survival rate of only 20%. Nevertheless, combined immunotherapy (IT) and chemotherapy has demonstrated efficacy in patients with advanced esophageal cancer. This study explored a novel therapeutic strategy and aimed to evaluate the efficacy and safety of CCRT + IT versus CCRT alone in patients with locally advanced unresectable ESCC. In this retrospective cohort study, data from 106 patients with locally advanced ESCC who underwent CCRT at the Department of Radiotherapy of the First Affiliated Hospital of Guangxi Medical University, between July 2019 and December 2022, were collected and analyzed. Among them, 60 patients received CCRT combined with IT (CCRT + IT group) and 46 patients received CCRT only (CCRT group). The prognosis and adverse events (AEs) were compared between the two groups. The baseline clinical characteristics were similar between the CCRT + IT and CCRT groups. However, the objective response rate (ORR) of the primary tumor was significantly better in the CCRT + IT group than in the CCRT group (76.7% vs. 52.2%; p = 0.008). Compared with the CCRT group, the 1-year progression-free survival (PFS) rate and median PFS were significantly higher in the CCRT + IT group (1-year PFS: 66.7% vs. 41.3%, p = 0.009; median PFS: 17.1 months vs. 9.8 months, p = 0.030). Additionally, both the OS rate and median OS were higher in the CCRT + IT group than in the CCRT group (1-year OS: 80.0% vs. 58.7%, p = 0.017; median OS: 19.6 months vs. 14.2 months, p = 0.087). The incidence of grade ≥ 3 AEs was low and did not significantly differ between groups. CCRT + IT is a promising treatment for locally advanced ESCC, offering remarkable efficacy and manageable toxicity.

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Cite This Study

Li et al. (Mon,) studied this question.

synapsesocial.com/papers/6a0414f679e20c90b4444c7d https://doi.org/https://doi.org/10.1186/s12885-026-16162-4

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