Induction Chemoimmunotherapy Versus Induction Chemotherapy Followed by Concurrent Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Study
- 1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China
Abstract
Background/Objectives: Induction chemotherapy offers limited survival benefit before definitive concurrent chemoradiotherapy in locally advanced esophageal squamous cell carcinoma. We compared induction chemoimmunotherapy followed by concurrent chemoradiotherapy (IOC-CCRT) with induction chemotherapy followed by concurrent chemoradiotherapy (IC-CCRT). Methods: This retrospective study included patients treated during 2017–2024. Propensity score matching was performed at a 2:1 ratio. Overall survival, progression-free survival, failure patterns, and treatment-related adverse events were evaluated. Results: Among 333 patients, 228 received IOC-CCRT and 105 received IC-CCRT. In the full cohort, IOC-CCRT was associated with better overall survival (p = 0.009) and progression-free survival (p = 0.005). After matching, 220 patients were included (141 IOC-CCRT and 79 IC-CCRT); IOC-CCRT remained associated with better overall survival (p = 0.0027) and progression-free survival (p = 0.0012). The 36-month overall survival rates were 59.0% versus 41.6%, and progression-free survival rates were 49.7% versus 28.0%. Overall failure occurred in 27.7% versus 39.2% of patients (p = 0.077). In multivariable analyses, the associations with progression-free survival (hazard ratio, 0.75; 95% confidence interval, 0.55–1.03; p = 0.075) and overall survival (hazard ratio, 0.82; 95% confidence interval, 0.58–1.14; p = 0.234) were not statistically significant. Grade 3 or higher neutropenia was more frequent with IOC-CCRT (31.9% versus 16.5%; p = 0.013); no grade ≥ 3 radiation pneumonitis occurred. Conclusions: IOC-CCRT was associated with improved unadjusted survival outcomes and increased selected severe toxicities compared with IC-CCRT. Prospective randomized trials are warranted.
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BibTeX
@article{liu2026induction,
title = {{Induction Chemoimmunotherapy Versus Induction Chemotherapy Followed by Concurrent Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Study}},
author = {Jiayue Liu and Wei Deng and Xin Dong and Yuting Zhao and Leilei Jiang and Liuhua Long and Yue Teng and Dan Yang and Jiayi Yu and Xiao Chang and Huiming Yu and Anhui Shi and Weihu Wang and Rong Yu},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208121},
url = {https://www.mdpi.com/2077-0383/15/20/8121},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Induction Chemoimmunotherapy Versus Induction Chemotherapy Followed by Concurrent Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Study
AU - Jiayue Liu
AU - Wei Deng
AU - Xin Dong
AU - Yuting Zhao
AU - Leilei Jiang
AU - Liuhua Long
AU - Yue Teng
AU - Dan Yang
AU - Jiayi Yu
AU - Xiao Chang
AU - Huiming Yu
AU - Anhui Shi
AU - Weihu Wang
AU - Rong Yu
PY - 2026
DA - 2026/10/19
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208121
UR - https://www.mdpi.com/2077-0383/15/20/8121
AB - Background/Objectives: Induction chemotherapy offers limited survival benefit before definitive concurrent chemoradiotherapy in locally advanced esophageal squamous cell carcinoma. We compared induction chemoimmunotherapy followed by concurrent chemoradiotherapy (IOC-CCRT) with induction chemotherapy followed by concurrent chemoradiotherapy (IC-CCRT). Methods: This retrospective study included patients treated during 2017–2024. Propensity score matching was performed at a 2:1 ratio. Overall survival, progression-free survival, failure patterns, and treatment-related adverse events were evaluated. Results: Among 333 patients, 228 received IOC-CCRT and 105 received IC-CCRT. In the full cohort, IOC-CCRT was associated with better overall survival (p = 0.009) and progression-free survival (p = 0.005). After matching, 220 patients were included (141 IOC-CCRT and 79 IC-CCRT); IOC-CCRT remained associated with better overall survival (p = 0.0027) and progression-free survival (p = 0.0012). The 36-month overall survival rates were 59.0% versus 41.6%, and progression-free survival rates were 49.7% versus 28.0%. Overall failure occurred in 27.7% versus 39.2% of patients (p = 0.077). In multivariable analyses, the associations with progression-free survival (hazard ratio, 0.75; 95% confidence interval, 0.55–1.03; p = 0.075) and overall survival (hazard ratio, 0.82; 95% confidence interval, 0.58–1.14; p = 0.234) were not statistically significant. Grade 3 or higher neutropenia was more frequent with IOC-CCRT (31.9% versus 16.5%; p = 0.013); no grade ≥ 3 radiation pneumonitis occurred. Conclusions: IOC-CCRT was associated with improved unadjusted survival outcomes and increased selected severe toxicities compared with IC-CCRT. Prospective randomized trials are warranted.
SN - 2077-0383
ER -