ArticleCancer immunology, immunotherapy : CII2025
Comparative analysis of immunochemotherapy with versus without radiation therapy for stage IVB esophageal squamous cell carcinoma confined to non-regional nodal metastases: a multicenter propensity score matching study.
Article in Cancer immunology, immunotherapy : CII, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors.
Funding
Abstract
backgroundThe survival benefit of adding radiotherapy (RT) to immunochemotherapy (ICT) in patients with stage IVB esophageal squamous cell carcinoma (ESCC) confined to non-regional lymph node metastases remains uncertain. This study evaluated whether RT combined with first-line PD-1 inhibitor-based ICT improves outcomes.
methodsIn this multicenter retrospective cohort study, 343 patients with stage IVB ESCC (non-regional nodal metastases only; AJCC 8th edition) treated with PD-1 inhibitors plus chemotherapy between 2019 and 2021 were analyzed. Patients were stratified into RT (ICT + RT, n = 181) and non-RT (ICT alone, n = 162) groups. Propensity score matching (PSM) balanced baseline characteristics (age, sex, metastatic sites, etc.), yielding 125 matched pairs. RT (> 40 Gy to primary lesions) was delivered via IMRT/VMAT (median dose, 50.4 Gy). Primary endpoints were overall survival (OS) and progression-free survival (PFS).
resultsAfter PSM, the RT group showed significantly longer median OS (22.3 vs 14.9 months; HR 0.51, 95% CI 0.37-0.71; P < 0.001) and PFS (14.0 vs 6.1 months; HR 0.57, 95% CI 0.42-0.77; P < 0.001) versus non-RT. Sequential RT (post-induction ICT) conferred maximal OS benefit (median OS 29.2 vs 12.1 months; HR 0.38, P < 0.001). Exploratory analysis indicated that the most significant survival benefit was observed in patients receiving sequential RT targeting the primary tumor with or without metastatic nodes, rather than metastasis-directed RT alone. Grade 3-5 treatment-related adverse events were comparable between groups; however, RT was associated with significantly higher rates of grade 3-4 lymphopenia (15.2% vs 4.0%, p = 0.004) and esophagitis (11.2% vs 0%, p < 0.001).
conclusionAdding RT to first-line ICT improves survival in stage IVB ESCC with non-regional nodal metastases, particularly when delivered sequentially to the primary tumor.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.