Abstract
BACKGROUND: This study assessed the efficacy and safety of radiotherapy (RT) plus immunochemotherapy in oligometastatic esophageal cancer (OMEC). METHODS: A single-center retrospective study of OMEC patients who received immunochemotherapy from Jan 2019 to Jan 2022. RESULTS: About 226 patients were included, which consisted of 108 cases in the RT plus immunochemotherapy group (iCRT), and 118 cases in the immunochemotherapy group (iCT). With a median follow-up of 22.2 months, the median progression-free survival (PFS) was 13.0 months for the iCRT group and 7.7 months for the iCT group (p < 0.001, HR = 0.520, 95%CI, 0.388-0.696). The median overall survival (OS) was 27.5 months for the iCRT group and 21.7 months for the iCT group (p = 0.026, HR = 0.670, 95%CI, 0.468-0.958). The iCRT group was associated with a higher risk of ≥grade 3 myelosuppression. No grade 5 treatment-related adverse events were observed. Univariate and multivariate analysis showed that a history of alcohol consumption, more metastatic lesions, and second-line and above treatment had inferior PFS in OMEC patients. A lower Karnofsky performance status score, more metastatic lesions, and second-line and above treatment were found to have inferior OS. CONCLUSION: Compared to immunochemotherapy alone, RT plus immunochemotherapy showed survival benefits with manageable safety for OMEC patients.