ArticleFrontiers in oncology2026
Efficacy and safety of radiotherapy combined with chemoimmunotherapy versus chemoimmunotherapy alone as first-line treatment for metachronous oligorecurrent esophageal squamous cell carcinoma.
Article in Frontiers in 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
Purpose: Metachronous oligorecurrence is usually defined as oligometastatic disease diagnosed more than 6 months after primary tumor diagnosis in the absence of active systemic therapy. This study aimed to assess the safety and efficacy of radiotherapy combined with chemoimmunotherapy (RCIT) versus chemoimmunotherapy (CIT) alone as the first-line treatment for metachronous oligorecurrent esophageal squamous cell carcinoma (MOR-ESCC). Methods: We retrospectively evaluated 195 patients with MOR-ESCC treated with first-line RCIT (n=102) or CIT (n=93) between June 2018 and June 2023. Propensity score matching (PSM) was performed to reduce baseline imbalance and potential confounding. Results: Following 1:1 PSM, 72 well-paired patients were identified. The median follow-up was 17.9 months. RCIT was associated with significantly longer progression-free survival (PFS) than CIT, while overall survival (OS) showed a borderline non-significant trend favoring RCIT. The median PFS was 13.1 months (95% CI: 8.9-17.3) in the RCIT group and 9.0 months (95% CI: 6.9-11.1) in the CIT group ( Conclusions: RCIT was associated with significantly prolonged PFS and numerically longer OS compared with CIT alone in patients with MOR-ESCC. Although no statistically significant increase in grade ≥3 TRAEs was observed, RCIT showed numerically higher toxicity, particularly pneumonitis. This study provides real-world evidence supporting the role of radiotherapy in MOR-ESCC, identifying long recurrence intervals (≥18 months), nodal-only recurrence, and low tumor burden (1-2 lesions/single organ) as key predictors of RCIT efficacy. These findings support RCIT as a potential strategy for carefully selected patients with MOR-ESCC, although the pneumonitis signal warrants cautious patient selection and prospective validation.
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