{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T08:07:40Z","timestamp":1774512460174,"version":"3.50.1"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"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. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to quantify the statistical cure in patients with unresectable locally advanced esophageal squamous cell carcinoma (LA-ESCC) treated with definitive radiotherapy (RT)-based strategies and to explore the independent prognostic factors of cure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Materials<\/jats:title>\n                    <jats:p>This retrospective study analyzed 801 patients with unresectable LA-ESCC at Affiliated Cancer Hospital of Zhengzhou University from 2014 to 2023. All patients received definitive RT and were stratified into chemoradiotherapy (CRT, n=689) or CRT combined with immunity checkpoint inhibitors (CRT+ICIs, n=112) based on treatment received. A relative survival (RS)-based mixture cure modeling methodology was used to estimate the cure fraction and cure point. The model was externally validated using a dataset of 5,000 matched patients from the SEER database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our model estimated a cure fraction of 10.4% and a cure point of 6.7 years. Subset analysis indicated that patients treated with CRT+ICIs had a higher cure fraction than those treated with CRT (30.6% vs 10.9%), with a shorter time to cure (3.9 vs 7.1 years). Validation with the SEER dataset showed a comparable cure fraction (10.8%) but a longer cure point (9.3 years). Multivariable analysis suggested that the favorable independent prognostic factors of statistical cure included a higher BMI (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      , 0.10; 95% CI, 0.01 to 0.19; p=0.039) and the CRT+ICIs regimen (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      , 2.18; 95% CI, 0.91 to 3.44; p&amp;lt;0.001). Factors associated with a lower probability of cure were age \u226565 years (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      -0.04; 95% CI, -0.09 to 0.00; p=0.032) and chronic comorbidities (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      , -1.10; 95% CI, -2.14 to -0.05; p=0.040).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Statistical cure is achievable in unresectable LA-ESCC patients receiving RT-based regimens. However, the traditional 5-year overall survival (OS) insufficiently reflects long-term survival, indicating that follow-up in the CRT group should be at least 7 years. Incorporation of ICIs facilitated curative potential and shortened cure point, supporting a 4-year OS surrogate endpoint for CRT+ICIs. These findings emphasize the value of integrating cure models into clinical practice to optimize individualized treatment and surveillance strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1768800","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T06:33:14Z","timestamp":1774506794000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantifying statistical cure in unresectable locally advanced esophageal squamous cell carcinoma treated with radiotherapy-based regimens: a cure model analysis with SEER validation"],"prefix":"10.3389","volume":"16","author":[{"given":"Nan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]},{"name":"Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan 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