新辅助化疗或放化疗联合免疫治疗局部可切除食管鳞癌的比较。

Comparison of neoadjuvant chemotherapy or chemoradiotherapy plus immunotherapy for locally resectable esophageal squamous cell carcinoma.

机构信息

Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.

Guangdong Esophageal Cancer Institute, Guangzhou, China.

出版信息

Front Immunol. 2024 May 8;15:1336798. doi: 10.3389/fimmu.2024.1336798. eCollection 2024.

BACKGROUND

Neoadjuvant chemotherapy plus immunotherapy (nCT + ICIs) and neoadjuvant chemoradiotherapy plus immunotherapy (nCRT + ICIs) both induced favorable pathological response and tolerant toxicities for locally resectable esophageal squamous cell carcinoma (ESCC). However, few studies compared safety and efficacy between the two treatment strategies.

METHODS

This retrospective study collected clinical data of locally resectable ESCC patients who underwent nCT + ICIs or nCRT + ICIs followed by esophagectomy from November 2019 to December 2022. The incidence of adverse events, surgical outcomes, short and long-term efficacy, and treatment costs were compared.

RESULTS

A total of 206 patients were included, with a ratio of 158:48 between nCT + ICIs group and nCRT + ICIs group. The two groups exhibited well-balanced baseline characteristics. Most adverse events were grade 1-2 in both groups. The nCT + ICIs group had a longer operative time (334.00 ± 170.2 min vs 279.60 ± 88.31 min, =0.020) than nCRT + ICIs group, but there were no differences in surgical complications. Although nCT + ICIs group had a lower pCR rate (32.3% vs 52.1%, =0.004), the 2-year overall survival (84.42% vs 81.70%, =0.860), 2-year disease-free survival (83.21% vs 80.47%, =0.839), and recurrence patterns were similar to nCRT + ICIs group. In addition, nCT + ICIs group had significantly lower expenses (188796.00 ± 107704.00 RMB vs 231808.00 ± 48067.00 RMB, =0.045).

CONCLUSION

Overall, nCT + ICIs have comparable safety and efficacy compared to nCRT + ICIs for locally resectable ESCC, but with lower hospitalization costs.

背景

新辅助化疗联合免疫治疗（nCT+ICIs）和新辅助放化疗联合免疫治疗（nCRT+ICIs）均能诱导局部可切除食管鳞癌（ESCC）获得有利的病理反应和耐受毒性。然而，很少有研究比较这两种治疗策略的安全性和疗效。

方法

本回顾性研究收集了 2019 年 11 月至 2022 年 12 月期间接受 nCT+ICIs 或 nCRT+ICIs 新辅助治疗后行食管切除术的局部可切除 ESCC 患者的临床资料。比较两组不良反应发生率、手术结果、短期和长期疗效和治疗费用。

结果

共纳入 206 例患者，nCT+ICIs 组和 nCRT+ICIs 组分别为 158 例和 48 例。两组患者基线特征均衡。两组大多数不良反应均为 1-2 级。nCT+ICIs 组的手术时间（334.00±170.2 分钟 vs. 279.60±88.31 分钟，=0.020）长于 nCRT+ICIs 组，但两组手术并发症无差异。尽管 nCT+ICIs 组的病理完全缓解率（32.3% vs. 52.1%，=0.004）较低，但两组 2 年总生存率（84.42% vs. 81.70%，=0.860）、2 年无病生存率（83.21% vs. 80.47%，=0.839）和复发模式相似。此外，nCT+ICIs 组的费用明显较低（188796.00±107704.00 人民币 vs. 231808.00±48067.00 人民币，=0.045）。