Chen Jiazhen, Miao Chuanwang, Wang Xiaoyue, Yang Liying, Wang Cunliang, Chen Yuanji, Zong Dan, Hu XuDong, He Xia
Department of Radiation Oncology, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, China.
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, China.
BMC Cancer. 2025 Aug 5;25(1):1270. doi: 10.1186/s12885-025-14682-z.
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.
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.
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).
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.
随着新辅助治疗在食管鳞状细胞癌（ESCC）管理中变得越来越重要，其可改善局部控制、R0切除率和总生存期，确定最佳新辅助治疗策略仍然是一个优先事项。本研究回顾性评估了新辅助免疫化疗（NICT）、放化疗（NCRT）和化疗（NCT）在可手术切除的ESCC中的疗效和安全性。
分析2018年1月至2022年8月在山东省肿瘤医院接受NICT、NCRT或NCT治疗的可切除ESCC患者的术前临床数据，我们重点关注手术并发症、病理反应和生存结果。
评估了300例患者的数据（91例NICT，113例NCRT，96例NCT）。与NCRT相比，NICT组手术并发症发生率较低（17.6%对36.3%，p = 0.003），与NCT相当（17.6%对22.9%，p = 0.365）。NICT的完全病理缓解率不如NCRT（p < 0.001），但优于NCT。值得注意的是，与NCRT（73.5%和84.1%，p = 0.187和p = 0.043）和NCT（44.8%和61.5%，两者p < 0.001）相比，NICT队列的2年无复发生存率（81.3%）和总生存率（93.4%）更高。
尽管病理缓解率略低，但NICT显著降低了手术并发症并改善了生存结果。它是可切除ESCC新辅助治疗中的一个有吸引力的选择，有可能取代NCRT和NCT。
