ArticleTranslational oncology2026
Concurrent immunoradiotherapy with Toripalimab versus concurrent chemoradiotherapy with S-1 in older patients with esophageal squamous cell carcinoma: a retrospective cohort study.
Article in Translational oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionEvidence for concurrent immunoradiotherapy (CIRT) in older patients with esophageal squamous cell carcinoma (ESCC) is limited, whereas S-1-based concurrent chemoradiotherapy (CCRT) has shown benefits.
methodsWe retrospectively included 47 older patients with ESCC treated with CIRT (n = 22) or CCRT (n = 25). Progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (AEs) were analyzed. Absolute lymphocyte count (ALC), pan-immune-inflammation value (PIV), platelet lymphocyte ratio (PLR), lymphocyte monocyte ratio (LMR), neutrophil lymphocyte ratio (NLR), and systemic inflammation response index (SIRI) were collected at four timepoints (pre-, during1-, during2-, post-) and explored using univariate and multivariate Cox models.
resultsObjective response rate and disease control rate were 77.3% and 90.9% with CIRT, and 100% with CCRT. Median PFS (9.67 vs 20.63 months; P = 0.042) and OS (13.67 vs 23.73 months; P = 0.045) were shorter with CIRT. Grade ≥ 3 AEs occurred in 72.7% (CIRT) and 96.0% (CCRT). Distant recurrence predominated with CIRT (66.7% of recurrences), while regional/local relapse was more common with CCRT (50.0%). ALC and LMR declined during therapy and partially recovered after treatment; PIV, PLR, NLR, and SIRI showed inverse dynamics. Treatment group, during1-ALC, and pre-SIRI were independent prognostic factors for OS. Patients receiving CIRT with low during1-ALC, high pre-SIRI/PIV, or high during1-PLR/NLR had the worst OS.
conclusionsCIRT was tolerable in older patients with ESCC but associated with inferior outcomes, though confounding cannot be excluded. Our analysis indicated a potential correlation between lymphocyte/monocyte dynamics and response, suggesting lymphopenia mitigation could improve efficacy.
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