{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:05:10Z","timestamp":1784613910308,"version":"3.55.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The real-world efficacy and prognostic factors of First-line and subsequent-line treatment for first-recurrent\/metastatic esophageal squamous cell cancer (ESCC) have not been fully evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-institutional retrospective cohort study evaluated 156 first-recurrent\/metastatic ESCC patients treated with First-line and subsequent-line treatment between January 2018 to January 2023. We assessed tumor response, long-term survival, and prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 156 ESCC patients with measurable lesions, in the first-line treatment setting, the combined Immunotherapy+Radiotherapy+Chemotherapy (IT+RT+CT) group had a lower incidence of progressive disease (PD) and Death compared with the Chemotherapy+Immunotherapy (CT+IT) group (80.0% vs 90.6%). First-Line Treatment were independent factors that affect progression-free survival (PFS), better PFS in the IT+RT+CT group compared to the CT+IT group (HR: 0.50, 95%CI: 0.28-0.90, P\u00a0=\u00a00.020). In the First-line and subsequent-line treatments, IT+RT+CT were identified as significant prognostic factors of overall survival (OS) through Cox proportional hazards analysis. After inverse probability of treatment weighting (IPTW) between the IT+RT+CT group and the CT+IT group in the First-line and Subsequent-line Treatments, the 1-, 2-year OS were 76.2% and 46.5% in the IT+RT+CT group, and 1-, 2-year OS were 39.5% and 19.4% in the CT+IT group, respectively (P\u00a0=\u00a00.011). In the doubly robust Cox proportional hazards model, which incorporated IPTW with weight trimming and adjustment for residual confounders (SMD&amp;gt;0.1), in the First-line and Subsequent-line Treatments, the IT+RT+CT regimen was significantly associated with improved OS compared to the CT+IT regimen (HR: 0.48, 95%CI: 0.27-0.85, P\u00a0=\u00a00.011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study demonstrated that, IT+RT+CT as first-line treatment for recurrent\/metastatic ESCC significantly prolonged PFS compared to CT+IT. Furthermore, IT+RT+CT extended OS in First-line and subsequent-line treatments. However, these findings require validation in prospective studies to confirm their clinical significance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1791354","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T05:35:40Z","timestamp":1784612140000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic analysis of first-recurrence\/metastasis esophageal squamous cell carcinoma: chemoimmunotherapy combined with radiotherapy as one of the optimal clinical management strategies"],"prefix":"10.3389","volume":"17","author":[{"given":"Yitong","family":"Li","sequence":"first","affiliation":[{"name":"The sixth Oncology Department, HeBei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaofang","family":"Li","sequence":"additional","affiliation":[{"name":"The Fifth Oncology Department, HeBei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo","family":"Wang","sequence":"additional","affiliation":[{"name":"The Fifth Oncology Department, HeBei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengchang","family":"Gao","sequence":"additional","affiliation":[{"name":"HeBei Sub bureau of North China Regional Air Traffic Management Bureau","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Tian","sequence":"additional","affiliation":[{"name":"The Fifth Oncology Department, HeBei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaomiao","family":"Liu","sequence":"additional","affiliation":[{"name":"The Fifth Oncology Department, HeBei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqing","family":"Bu","sequence":"additional","affiliation":[{"name":"The Fifth Oncology Department, HeBei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Cui","sequence":"additional","affiliation":[{"name":"The Fifth Oncology Department, HeBei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1080\/14740338.2021.1955100","article-title":"The safety of current treatment options for advanced esophageal cancer after first-line chemotherapy","volume":"21","author":"Ikeda","year":"2022","journal-title":"Expert Opin Drug 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