Wang Bing, Liu Tianxing, Yang Zhe, Zhu Hui, Zhou Fengge, Li Li, Feng Bin, Jing Wang
Department of Medical Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Shandong University, Shandong Provincial Hospital, Jinan, China.
Front Immunol. 2025 Aug 22;16:1634834. doi: 10.3389/fimmu.2025.1634834. eCollection 2025.
Small cell carcinoma of the esophagus (SCCE) is a rare neuroendocrine malignancy with no standardized treatment regimen. This study aims to evaluate the impact of immunotherapy on the prognostic survival outcomes of patients with SCCE.
A retrospective analysis was conducted on 83 SCCE patients treated at the Provincial Hospital of Shandong First Medical University and the Cancer Hospital of Shandong First Medical University from January 2020 to June 2024. Propensity score matching (PSM) was applied to minimize potential biases between patients who received combination immunotherapy and those who did not. Survival outcomes, including overall survival (OS) and progression-free survival (PFS), were assessed using the Kaplan-Meier method, while univariate and multivariate analyses were performed using the Cox proportional hazards model.
Among the 83 patients included, 33 received combination immunotherapy and 50 did not. Prior to PSM, clinicopathological comparisons revealed that tumor size was significantly larger in the non-immunotherapy group (P = 0.032), and the immunotherapy group had more advanced N stages (P = 0.015). After 1:1 PSM, 20 matched pairs were analyzed. The immunotherapy group demonstrated a significantly longer OS compared to the non-immunotherapy group (22 months . 13 months, P = 0.0165), though PFS differences were not statistically significant (9 months . 7 months, P > 0.05). Univariate and multivariate analyses identified treatment methods (P=0.039) as independent prognostic factors for OS. Survival rate analysis showed that patients in the immunotherapy group achieved superior six-month (97.0% . 83.7%), one-year (78.9% . 56.5%), and two-year (22.1% . 10.4%) survival rates compared to the non-immunotherapy group.
This study demonstrates that combination immunotherapy significantly improves overall survival in SCCE patients and represents an effective treatment strategy for this rare malignancy.
食管小细胞癌（SCCE）是一种罕见的神经内分泌恶性肿瘤，尚无标准化治疗方案。本研究旨在评估免疫治疗对SCCE患者预后生存结局的影响。
对2020年1月至2024年6月在山东第一医科大学省立医院和山东第一医科大学附属肿瘤医院接受治疗的83例SCCE患者进行回顾性分析。应用倾向评分匹配（PSM）以尽量减少接受联合免疫治疗患者与未接受联合免疫治疗患者之间的潜在偏倚。采用Kaplan-Meier法评估总生存（OS）和无进展生存（PFS）等生存结局，同时使用Cox比例风险模型进行单因素和多因素分析。
在纳入的83例患者中，33例接受联合免疫治疗，50例未接受。在PSM之前，临床病理比较显示非免疫治疗组的肿瘤大小显著更大（P = 0.032），且免疫治疗组的N分期更晚（P = 0.015）。经过1:1 PSM后，分析了20对匹配病例。与非免疫治疗组相比，免疫治疗组的OS显著更长（22个月对13个月，P = 0.0165），尽管PFS差异无统计学意义（9个月对7个月，P>0.05）。单因素和多因素分析确定治疗方法（P = 0.039）为OS的独立预后因素。生存率分析表明，与非免疫治疗组相比，免疫治疗组患者在6个月（97.0%对83.7%）、1年（78.9%对56.5%）和2年（22.1%对10.4%）时的生存率更高。
本研究表明联合免疫治疗可显著改善SCCE患者的总生存，是这种罕见恶性肿瘤的一种有效治疗策略。
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