本研究旨在调查诱导免疫化疗在放疗（RT）前治疗局部晚期或转移性食管癌患者的疗效。分别在两个癌症中心回顾性分析了接受诱导免疫化疗并接受RT（ICIs + RT组）及单纯RT（RT组）治疗的不可切除局部晚期或转移性食管癌患者。使用倾向性评分匹配（PSM）来平衡两组之间的潜在混杂因素。评估了总生存期（OS）、无进展生存期（PFS）和复发模式。共回顾了467名患者，每组匹配了66名患者。PSM后，ICIs + RT组1年和2年的OS率分别为84.6%和57.9%，RT组分别为71.1%和43.0%（HR 0.60，95% CI 0.36-1.00，p = 0.050）。相对于RT组，ICIs + RT组的OS的限制平均生存时间（RMST）增加了0.89年（p = 0.023）和2.59年（p = 0.030）。ICIs + RT组的中位PFS时间、1年和2年的PFS率分别为20.3个月、69.3%和45.7%，RT组分别为12.2个月、51.4%和35.8%（HR 0.64，95% CI 0.41-0.99，p = 0.045）。ICIs + RT组的局部区域复发（LRR）累积率显著低于RT组（1年率分别为17.4% vs. 38.8%，p = 0.011），而远程转移（DM）率相当（p = 0.755）。巩固性ICIs与1年OS和PFS的改善趋势相关。诱导免疫化疗后进行RT可能改善不可切除局部晚期或转移性食管癌患者的局部区域控制和生存预后。版权所有©2023 Elsevier B.V.保留所有权利。

The study aimed to investigate the efficacy of induction immunochemotherapy before radiotherapy (RT) for patients with locally advanced or metastatic esophageal cancer.Patients with unresectable locally advanced or metastatic esophageal cancer who received induction immunochemotherapy followed by RT (ICIs + RT group) and RT alone (RT group) were retrospectively identified in two cancer centers, respectively. Propensity score matching (PSM) was used to balance the potential confounders between the two groups. Overall survival (OS), progression-free survival (PFS), and recurrence patterns were evaluated.A total of 467 patients were reviewed, and 66 were matched in each group. After PSM, the 1- and 2-year OS rates were 84.6% and 57.9% in ICIs + RT group, and 71.1% and 43.0% in RT group (HR 0.60, 95% CI 0.36-1.00, p = 0.050). The absolute increase of restricted mean survival time (RMST) for OS in ICIs + RT group compared with RT group were 0.89 years (p = 0.023) at one year and 2.59 years at two years (p = 0.030). The median PFS time, 1- and 2-year PFS rates were 20.3 months, 69.3%, and 45.7% in ICIs + RT group, and 12.2 months, 51.4%, and 35.8% in RT group (HR 0.64, 95% CI 0.41-0.99, p = 0.045). The cumulative locoregional recurrence (LRR) rate was significantly lower in ICIs + RT group (1-year rate, 17.4% vs. 38.8%, p = 0.011), and distant metastasis (DM) rates were comparable (p = 0.755). Consolidation ICIs was associated with a trend of improved 1-year OS and PFS.Induction immunochemotherapy followed by RT might improve locoregional control and survival outcomes for patients with unresectable locally advanced or metastatic esophageal cancer.Copyright © 2023 Elsevier B.V. All rights reserved.