Survival benefits of immunotherapy combined with chemoradiotherapy in metastatic colorectal cancer: an analysis based on data from the SEER database.

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Open Medicine Pub Date : 2026-04-27 eCollection Date: 2026-01-01 DOI:10.1515/med-2026-1416

Jie Zhang, Weijuan Jiang

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引用次数: 0

Abstract

Objectives: Chemoradiotherapy (CRT) alone shows limited efficacy in improving outcomes for metastatic colorectal cancer (mCRC) patients. This study aimed to comprehensively evaluate the survival benefits of combining CRT with immunotherapy (CRT + IMT) in this population.

Methods: Data from the SEER database were extracted for mCRC patients diagnosed between 2010-2015 and 2018-2020. Survival outcomes were assessed using Kaplan-Meier analysis, log-rank test, Cox regression, and propensity score matching (PSM) to minimize baseline differences between treatment groups, and multivariable Cox models were constructed based on variables selected by LASSO regression.

Results: A total of 2,451 patients were identified, with 1,888 receiving CRT alone and 563 CRT + IMT. After 1:2 PSM, 1,594 remained. Kaplan-Meier curves showed CRT + IMT significantly improved overall survival (OS, p<0.0001) and cancer-specific survival (CSS, p<0.0001). Multivariable Cox confirmed CRT + IMT as an independent predictor (OS HR=0.54, 95 % CI: 0.44-0.65; CSS HR=0.54, 95 % CI: 0.44-0.66). Favorable factors included distal colon/rectal tumors, surgery, and combined therapy, while older age (>60), advanced stage, N2, and metastasis predicted worse survival. The subgroup analyses revealed a more pronounced benefit in specific cohorts, and significant interactions were observed for factors such as histologic grade and nodal stage.

Conclusions: The combination of CRT and immunotherapy confers a significant survival advantage over CRT alone in patients with mCRC, supporting its potential role in optimized treatment strategies.

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免疫治疗联合放化疗对转移性结直肠癌的生存益处：基于SEER数据库数据的分析

目的：单纯放化疗（CRT）在改善转移性结直肠癌（mCRC）患者预后方面疗效有限。本研究旨在全面评估CRT联合免疫治疗（CRT + IMT）在该人群中的生存益处。方法：从SEER数据库中提取2010-2015年和2018-2020年诊断的mCRC患者的数据。使用Kaplan-Meier分析、log-rank检验、Cox回归和倾向评分匹配（PSM）来评估生存结果，以尽量减少治疗组之间的基线差异，并根据LASSO回归选择的变量构建多变量Cox模型。结果：共发现2451例患者，其中单独接受CRT治疗1888例，CRT + IMT治疗563例。1:2 PSM后，剩下1,594人。Kaplan-Meier曲线显示，CRT + IMT显著改善总生存期（OS, p60），晚期、N2和转移预示更差的生存期。亚组分析显示，在特定队列中有更明显的益处，并观察到组织学分级和淋巴结分期等因素的显著相互作用。结论：在mCRC患者中，CRT联合免疫治疗比单独CRT具有显著的生存优势，支持其在优化治疗策略中的潜在作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Medicine Medicine-General Medicine

CiteScore

3.00

自引率

0.00%

发文量

153

审稿时长

20 weeks

期刊介绍： Open Medicine is an open access journal that provides users with free, instant, and continued access to all content worldwide. The primary goal of the journal has always been a focus on maintaining the high quality of its published content. Its mission is to facilitate the exchange of ideas between medical science researchers from different countries. Papers connected to all fields of medicine and public health are welcomed. Open Medicine accepts submissions of research articles, reviews, case reports, letters to editor and book reviews.