Zhao Junfeng, Hao Shaoyu, Tian Jing, Li Ying, Han Dan
Department of Radiation Oncology, Shandong University Cancer Center, Jinan, Shandong, People's Republic of China.
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, and Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China.
J Inflamm Res. 2023 Aug 8;16:3351-3363. doi: 10.2147/JIR.S424454. eCollection 2023.
This study compares the efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy (NICT) and neoadjuvant chemoradiotherapy (NCRT) combined with radical esophagectomy in patients with resectable, locally advanced esophageal squamous cell cancer (ESCC).
Patients with locally advanced ESCC treated with NICT or NCRT combined with esophagectomy between March 2016 and May 2022 were retrospectively analyzed and propensity score matched (PSM) in a 1:2 ratio to balance potential bias.
After PSM, 110 patients who received NCRT and 55 patients who received NICT were selected for the final analysis. The probability of tumor regression grade 0 and the rate of pathological complete remission (pCR) were significantly higher in the NCRT group than in the NICT group (57.3% vs 32.7%, =0.003 and 48.2% vs 29.1%, =0.030, respectively). The incidence of postoperative complications in the NCRT group was not significantly different from that in the NICT group (=0.082). Patients in the NCRT group had significantly better disease-free survival (DFS) and overall survival (OS) than those in the NICT group (12-month DFS rate: 94.3% vs 81.8%, =0.006; 12-month OS rate: 100.0% vs 95.4%, =0.032). However, the results of the 24-month follow-up showed that there was also a statistically significant difference in DFS between the two groups. Patients with postoperative pCR had a longer DFS (< 0.001).
Short-term follow-up results show that NCRT has a significantly better pathologic response and prognosis than NICT in the treatment of patients with locally advanced ESCC. NCRT and NICT have similar safety profiles.
本研究比较新辅助免疫治疗联合化疗（NICT）与新辅助放化疗（NCRT）联合根治性食管切除术治疗可切除的局部晚期食管鳞状细胞癌（ESCC）患者的疗效和安全性。
回顾性分析2016年3月至2022年5月期间接受NICT或NCRT联合食管切除术治疗的局部晚期ESCC患者，并按1:2的比例进行倾向评分匹配（PSM），以平衡潜在偏倚。
PSM后，选择110例接受NCRT的患者和55例接受NICT的患者进行最终分析。NCRT组的肿瘤消退0级概率和病理完全缓解（pCR）率显著高于NICT组（分别为57.3%对32.7%，P=0.003；48.2%对29.1%，P=0.030）。NCRT组术后并发症发生率与NICT组无显著差异（P=0.082）。NCRT组患者的无病生存期（DFS）和总生存期（OS）显著优于NICT组（12个月DFS率：94.3%对81.8%，P=0.006；12个月OS率：100.0%对95.4%，P=0.032）。然而，24个月随访结果显示两组之间的DFS也存在统计学显著差异。术后pCR患者的DFS更长（P<0.001）。
短期随访结果表明，在治疗局部晚期ESCC患者时，NCRT的病理反应和预后明显优于NICT。NCRT和NICT的安全性相似。
