Background: Adjuvant immunotherapy has been shown in clinical trials to prolong the survival of patients with esophageal cancer. We report our initial experience with immunotherapy within an integrated health system. Methods: A retrospective cohort study was performed reviewing patients undergoing minimally invasive esophagectomy at our institution between 2017 and 2021. The immunotherapy cohort was assessed for completion of treatment, adverse effects, and disease progression, with emphasis on patients who received surgery in 2021 and their eligibility to receive nivolumab. Results: There were 39 patients who received immunotherapy and 137 patients who did not. In logistic regression, immunotherapy was not found to have a statistically significant impact on 1-year overall survival after adjusting for age and receipt of adjuvant chemoradiation. Only seven patients out of 39 who received immunotherapy successfully completed treatment (18%), with the majority failing therapy due to disease progression or side effects. Of the 17 patients eligible for nivolumab, 13 patients received it (76.4%), and three patients completed a full course of treatment. Conclusions: Despite promising findings of adjuvant immunotherapy improving the survival of patients with esophageal cancer, real-life practice varies greatly from clinical trials. We found that the majority of patients were unable to complete immunotherapy regimens with no improvement in overall 1-year survival.
背景：临床试验已证实辅助免疫疗法可延长食管癌患者的生存期。本文报告我们在整合医疗体系内开展免疫治疗的初步经验。方法：本研究采用回顾性队列设计，纳入2017至2021年间在本机构接受微创食管切除术的患者。重点评估免疫治疗组的治疗完成情况、不良反应及疾病进展，特别关注2021年接受手术患者及其接受纳武利尤单抗治疗的适用性。结果：共纳入39例接受免疫治疗患者及137例未接受免疫治疗患者。经逻辑回归分析校正年龄及辅助放化疗因素后，免疫治疗对患者术后1年总生存率无统计学显著影响。39例免疫治疗患者中仅7例（18%）顺利完成治疗，多数患者因疾病进展或副作用终止治疗。在17例符合纳武利尤单抗治疗指征的患者中，13例（76.4%）接受治疗，其中仅3例完成全程治疗。结论：尽管辅助免疫疗法在改善食管癌患者生存方面展现出前景，但临床实践与试验结果存在显著差异。本研究发现多数患者无法完成免疫治疗方案，且1年总生存率未见改善。
肿瘤(癌症)患者之家