Neoadjuvant immunochemotherapy versus neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy for resectable esophageal squamous cell carcinoma: a clinical retrospective study
Jiazhen Chen,
Chuanwang Miao,
Xiaoyue Wang,
Liying Yang,
Cunliang Wang,
Yuanji Chen,
Dan Zong,
XuDong Hu,
Xia He
Affiliations
Jiazhen Chen
Department of Radiation Oncology, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research
Chuanwang Miao
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science
Xiaoyue Wang
Department of Interventional Therapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science
Liying Yang
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science
Cunliang Wang
Department of Radiation Oncology, Linyi Cancer Hospital
Yuanji Chen
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science
Dan Zong
Department of Radiation Oncology, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research
XuDong Hu
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science
Xia He
Department of Radiation Oncology, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research
Abstract Background As neoadjuvant therapies become increasingly crucial in the management of esophageal squamous cell carcinoma (ESCC), improving local control, R0 resection rates, and overall survival, determining the optimal neoadjuvant strategy remains a priority. This study retrospectively assesses the efficacy and safety of neoadjuvant immunochemotherapy (NICT), chemoradiotherapy (NCRT), and chemotherapy (NCT) in operable ESCC. Methods Analyzing preoperative clinical data from resectable ESCC patients treated with NICT, NCRT, or NCT at Shandong Cancer Hospital from January 2018 to August 2022, we focused on surgical complications, pathological responses, and survival outcomes. Results Data from 300 patients (91 NICT, 113 NCRT, 96 NCT) were evaluated. The NICT group showed a lower incidence of surgical complications compared to NCRT (17.6% vs. 36.3%, p = 0.003) and was on par with NCT (17.6% vs. 22.9%, p = 0.365). NICT had less favorable complete pathological response rates than NCRT (p < 0.001) but outperformed NCT. Notably, the NICT cohort achieved superior 2-year recurrence-free (81.3%) and overall survival (93.4%) compared to NCRT (73.5% and 84.1%, p = 0.187 and p = 0.043) and NCT (44.8% and 61.5%, p < 0.001 for both). Conclusion Despite a slightly lower rate of pathological remission, NICT significantly reduced surgical complications and improved survival outcomes. It presents a compelling option in the neoadjuvant treatment of resectable ESCC, with the potential to supersede NCRT and NCT.
