Esophageal Squamous Cell Carcinoma (ESCC)
Conditions
Brief summary
This retrospective real-world study aimed to compare neoadjuvant immunochemotherapy (NICT) and neoadjuvant chemoradiotherapy (NCRT) followed by esophagectomy in patients with locally advanced esophageal squamous cell carcinoma (ESCC). A total of 203 consecutive patients treated at Sichuan Cancer Hospital between March 2018 and March 2022 were analyzed (NICT: 59; NCRT: 144). The primary endpoints were overall survival (OS) and disease-free survival (DFS); secondary endpoints included pathological complete response (pCR), tumor regression grade (TRG), and R0 resection rate. After inverse probability of treatment weighting adjustment, baseline characteristics were balanced between groups. Both groups achieved comparable long-term OS and DFS, while NCRT showed higher rates of local pathological response. Exploratory subgroup analysis suggested that patients achieving pCR after NICT might have superior survival outcomes. The study indicates that NICT provides similar long-term survival compared to NCRT and may offer immunologic advantages for selected responders, warranting further validation in prospective multicenter trials.
Interventions
DRUGNeoadjuvant Chemoradiotherapy
NCRT group patients followed the concurrent NCRT treatment, and the total neoadjuvant radiotherapy dose was 40.0-50.4Gy with 1.8-2.14 Gy fractions and 5 fractions/week.
NACI group patients received treatment of minimally 2 cycles of ICIs agent (mainly camrelizumab or toripalimab, 200 mg every 3 weeks (200 mg every 3 weeks)) combined with concurrent chemotherapy.
Sponsors
Yongtao Han
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age 18-80 years * Histologically confirmed thoracic ESCC * Clinical stage cT1N+M0 or cT2-4aN0-3M0 * Received neoadjuvant therapy (immunochemotherapy or chemoradiotherapy) followed by esophagectomy
Exclusion criteria
* History of other malignancies * Did not complete neoadjuvant therapy or required salvage surgery * Incomplete baseline or follow-up data
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival (OS) | 5 years | Time from first treatment to death from any cause or last follow-up. |
| Disease-Free Survival (DFS) | 5 years | Time from surgery to recurrence, death, or last follow-up. |
Secondary
| Measure | Time frame |
|---|---|
| Pathological Complete Response (pCR) rate | 3 months |
| Tumor Regression Grade (TRG) | 3 months |
| R0 resection rate | 3 months |
Countries
China
Outcome results
None listed