PD-1抑制剂联合化疗治疗老年复发性食管鳞状细胞癌的疗效和安全性

doi:10.3969/j.issn.1003-9198.2026.05.010

Abstract

Abstract: Objective To evaluate the efficacy and safety of programmed cell death protein 1 (PD-1) inhibitor combined with chemotherapy in elderly patients with locoregionally recurrent esophageal squamous cell carcinoma (ESCC) after definitive radiotherapy or chemoradiotherapy. Methods This study enrolled 94 elderly patients with ESCC who presented with locoregional recurrence after definitive radiotherapy or chemoradiotherapy and received PD-1 inhibitor combined with chemotherapy at Jiangsu Cancer Hospital from 2018 to 2024. The short-term efficacy, long-term outcomes, and adverse reactions were recorded. Univariate and multivariate Cox regression models were established to identify the factors influencing overall survival (OS) and progression-free survival (PFS). Results The Objective response rate (ORR) was 28.7% (27/94) with a disease control rate (DCR) of 87.2% (82/94). With a median follow-up of 26.1 months, the median OS and median PFS were 13.1 months (95%CI: 10.2-16) and 8.6 months (95%CI: 5.9-11.3), respectively. Univariate Cox regression analysis revealed that post-recurrence Eastern Cooperative Oncology Group (ECOG) performance status and response to treatment were significantly associated with both OS and PFS, while recurrence pattern was significantly associated with PFS (all P<0.05). Multivariate Cox regression analysis identified that post-recurrence ECOG performance status was independent influencing factor for OS, and post-recurrence ECOG performance status, recurrence pattern, and response to treatment were independent influencing factors for PFS. A total of 82 patients (87.2%) presented with treatment-related adverse events (TRAEs), and 22 patients (23.4%) experienced ≥grade 3 events. Common TRAEs included hematologic toxicity and hepatic/renal dysfunction. Immune-related adverse events were also observed. No treatment-related deaths occurred. Conclusions PD-1 inhibitors combined with chemotherapy in elderly patients demonstrate a favorable safety profile and significant efficacy for locoregionally recurrent ESCC after definitive radiotherapy or chemoradiotherapy, representing a viable therapeutic option for survival benefit.

Key words: esophageal squamous cell carcinoma, local recurrence, aged, immunotherapy, programmed cell death protein 1, chemotherapy

CLC Number:

R 735.1

SHI Yuxi, GU Dayong, ZHOU Lei, LIU Wenqian, WEN Linchun, YE Jinjun. Efficacy and safety of PD-1 inhibitor combined with chemotherapy for recurrent esophageal squamous cell carcinoma in the elderly[J]. Practical Geriatrics, 2026, 40(5): 484-489.

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Efficacy and safety of PD-1 inhibitor combined with chemotherapy for recurrent esophageal squamous cell carcinoma in the elderly

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