Department of Radiation Oncology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
Curr Oncol. 2022 Apr 20;29(5):2920-2927. doi: 10.3390/curroncol29050238.
In this study, we aimed to evaluate the efficacy of PD-1 inhibitors in combination with concurrent CRT/CT for patients with inoperable ESCC in the real world and to find predictors for the efficacy of PD-1 inhibitors. Patients with unresectable ESCC were evaluated at baseline. The clinical data of patients with ESCC who received CRT/CT with or without PD-1 inhibitor were collected and retrospectively reviewed. The objective response rate (ORR), overall survival (OS), and progression-free survival (PFS) were analyzed statistically. A total of 96 patients with ESCC were included. As compared with a control group (n = 48), the PFS (6.0 months vs. 5.0 months, p = 0.025) and 6-month OS (70.8% vs. 47.9%, p < 0.001) were significantly longer in the ICIs group (n = 48). There were no significant differences in ORR and 12-month OS between the two groups. In addition, we found that body mass index (BMI) was associated with PFS (HR 0.85, 95% CI 0.76−0.95, and p = 0.004) and OS (HR 0.82, 95% CI 0.69−0.98, and p = 0.033) in the ICIs group. PD-1 inhibitors combined with CRT/CT is safe with acceptable complications and improved survival for patients with inoperable ESCC. CRT plus PD-1 inhibitor has superior antitumor efficacy. BMI was positively correlated with the efficacy of PD-1 inhibitors.
在这项研究中，我们旨在评估 PD-1 抑制剂联合同期放化疗（CRT/CT）治疗不可切除的 ESCC 患者的疗效，并寻找 PD-1 抑制剂疗效的预测因素。在基线时评估不可切除 ESCC 患者。收集并回顾性分析接受 CRT/CT 联合或不联合 PD-1 抑制剂治疗的 ESCC 患者的临床数据。统计分析客观缓解率（ORR）、总生存期（OS）和无进展生存期（PFS）。共纳入 96 例 ESCC 患者。与对照组（n=48）相比，ICIs 组（n=48）的 PFS（6.0 个月比 5.0 个月，p=0.025）和 6 个月 OS（70.8%比 47.9%，p<0.001）显著延长。两组之间 ORR 和 12 个月 OS 无显著差异。此外，我们发现 BMI 与 ICIs 组的 PFS（HR 0.85，95%CI 0.76-0.95，p=0.004）和 OS（HR 0.82，95%CI 0.69-0.98，p=0.033）相关。PD-1 抑制剂联合 CRT/CT 治疗不可切除的 ESCC 安全，并发症可接受，且生存获益提高。CRT 联合 PD-1 抑制剂具有优越的抗肿瘤疗效。BMI 与 PD-1 抑制剂的疗效呈正相关。
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