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Updated: May 19, 2026
Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019
Concurrent immunoradiotherapy with Toripalimab versus concurrent chemoradiotherapy with S-1 in older patients with
Yixin Huang1, Chao Zhou2, Jian Zhu2
1Key Laboratory of Radiation Oncology of Taizhou, Department of Radiation Oncology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, 317000 Zhejiang Province, China; Department of Radiation Medicine, School of Public Health, Wenzhou Medical University, China.
Introduction:
Evidence for concurrent immunoradiotherapy (CIRT) in older patients with esophageal squamous cell carcinoma (ESCC) is limited, whereas S-1-based concurrent chemoradiotherapy (CCRT) has shown benefits.
Methods:
We retrospectively included 47 older patients with ESCC treated with CIRT (n = 22) or CCRT (n = 25). Progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (AEs) were analyzed. Absolute lymphocyte count (ALC), pan-immune-inflammation value (PIV), platelet lymphocyte ratio (PLR), lymphocyte monocyte ratio (LMR), neutrophil lymphocyte ratio (NLR), and systemic inflammation response index (SIRI) were collected at four timepoints (pre-, during1-, during2-, post-) and explored using univariate and multivariate Cox models.
Results:
Objective response rate and disease control rate were 77.3% and 90.9% with CIRT, and 100% with CCRT. Median PFS (9.67 vs 20.63 months; P = 0.042) and OS (13.67 vs 23.73 months; P = 0.045) were shorter with CIRT. Grade ≥ 3 AEs occurred in 72.7% (CIRT) and 96.0% (CCRT). Distant recurrence predominated with CIRT (66.7% of recurrences), while regional/local relapse was more common with CCRT (50.0%). ALC and LMR declined during therapy and partially recovered after treatment; PIV, PLR, NLR, and SIRI showed inverse dynamics. Treatment group, during1-ALC, and pre-SIRI were independent prognostic factors for OS. Patients receiving CIRT with low during1-ALC, high pre-SIRI/PIV, or high during1-PLR/NLR had the worst OS.
Conclusions:
CIRT was tolerable in older patients with ESCC but associated with inferior outcomes, though confounding cannot be excluded. Our analysis indicated a potential correlation between lymphocyte/monocyte dynamics and response, suggesting lymphopenia mitigation could improve efficacy.
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