Analysis of the efficacy and safety of Toripalimab combined with Capecitabine and concurrent volumetric modulated arc therapy in the treatment of locally advanced or advanced esophageal squamous cell carcinoma

LIN Xingguang; WU Yansheng

doi:10.13431/j.cnki.immunol.j.20260019

Abstract：Objective To observe the efficacy and safety of Toripalimab(JS001)combined with Capecitabine(CAPE)and concurrent volumetric modulated arc therapy(VMAT)in the treatment of locally advanced or advanced esophageal squamous cell carcinoma(ESCC).Methods From November 2022 to November 2023,105 patients with locally advanced or advanced ESCC were selected and divided into the observation group(n=54)and the control group(n=51)according to different treatment regimens.The observation group was treated with JS001 combined with CAPE and concurrent VMAT,while the control group was treated with CAPE and concurrent VMAT.CAPE treatment was administered in 21-day courses for a total of 4 cycles;VMAT was administered 5 times per week,for a total of 30 times;JS001 treatment was administered in 2-week courses for a total of 6 cycles.After the completion of all treatments,the efficacy and safety were evaluated at 4 weeks after the end of treatment,and tumor markers[carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC-Ag)],cellular immune function indicators(CD3+,CD8+),and survival status after 1-year follow-up were compared between the two groups.Results After treatment,the objective response rate(ORR)of the observation group was higher than that of the control group(P＜0.05).After treatment,the levels of CES and SCC-Ag in both groups were lower than those before treatment,which were lower in the observation group than in the control group(P＜0.05,P＜0.01).After treatment,the levels of CD3+in both groups were higher than those before treatment,and the levels in the observation group were higher than those in the control group(P＜0.05,P≤0.01).After treatment,the levels of CD8+in both groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(P＜0.05,P＜0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).The 1-year survival rate of the observation group was 64.81％(35/54),which was higher than that of the control group(49.02％,25/51),and the Kaplan-Meier survival curve showed a significant difference between the two groups(Log-rank x2=4.395,P=0.036).Conclusion The combination of JS001,CAPE and concurrent VMAT for the treatment of locally advanced or advanced ESCC can improve the ORR and 1-year survival rate of patients,regulate tumor markers and cellular immune function,and has good safety.