Case Presentation
The 51-year-old male patient was diagnosed with lower thoracic esophageal and received radical esophagectomy cancer surgery in the Second Affiliated Hospital of Soochow University in February 2020. The left recurrent laryngeal nerve was invaded by paraesophageal lymph nodes and cannot be dissociated by operation, resulting in incomplete resection of the lymph nodes (Supplementary Figure1). Postoperative pathology suggested a moderately differentiated squamous cell carcinoma with staged pT3N1M0 stage IIIB (AJCC 8th edition). The Eastern Cooperative oncology Group (ECOG) performance status score of he was 1.The immunohistochemical results showed CK7 (+), CK5/6 (+), P63 (+), P53 (+), EGFR (-), HER-2 (weak+), CEA (-), Syn (-), β-linked protein (membrane +), EBER (-), MLH1 (+), PMS2 (+), MLH2 (+), MLH6 (+) and Ki67 (+40%).The immunohistochemical results showed PD-L1 CPS (Combined Positive Score) was 70% (Figure 1). The patient received intensity-modulated radiotherapy (IMRT) from April 27, 2020, to June 6, with a dose fraction of 60Gy/30f for upper mediastinal paraoesophageal metastatic lymph nodes and thoracic para-aortic metastatic lymph nodes,
