Neoadjuvant chemoimmunotherapy versus chemoradiotherapy for esophageal squamous cell carcinoma: a multicenter cohort study.
Neoadjuvant chemoimmunotherapy and chemoradiotherapy showed similar disease-free survival in esophageal squamous cell carcinoma
Neoadjuvant chemoimmunotherapy versus chemoradiotherapy for esophageal squamous cell carcinoma: a multicenter cohort study.
The comparative efficacy of neoadjuvant chemoimmunotherapy (neoadjuvant chemoimmunotherapy) vs neoadjuvant chemoradiotherapy (neoadjuvant chemoradiotherapy) for locally advanced esophageal squamous cell carcinoma (locally advanced esophageal squamous cell carcinoma) remains controversial.
This multicenter retrospective cohort study included patients with locally advanced esophageal squamous cell carcinoma who received neoadjuvant chemoimmunotherapy or neoadjuvant chemoradiotherapy followed by esophagectomy across 7 Chinese medical centers between January 2012 and January 2024.
HR near 1 with CI crossing 1 indicates no significant difference in disease-free survival.
Among 2535 enrolled patients, 1414 received neoadjuvant chemoimmunotherapy and 1121 received neoadjuvant chemoradiotherapy.
The 2-year DFS rates were 68.7% (neoadjuvant chemoimmunotherapy) vs 72.0% (neoadjuvant chemoradiotherapy), and 2-year OS rates were 81.3% vs 83.7%, respectively.
Neoadjuvant chemoimmunotherapy showed a trend toward improved distant metastasis-free survival (distant metastasis-free survival) (HR, 0.87; 95% CI, 0.69-1.11; P = .27), whereas neoadjuvant chemoradiotherapy was associated with a trend toward improved locoregional recurrence-free survival (locoregional recurrence-free survival) (HR, 1.22; 95% CI, 0.96-1.56; P = .11).
Neoadjuvant chemoimmunotherapy and neoadjuvant chemoradiotherapy demonstrated comparable DFS and OS.
These findings suggest that both modalities are valid neoadjuvant strategies, possessing differing strengths in local vs systemic tumor control. These observations await confirmation in prospective trials.