Neoadjuvant Chemoradiotherapy vs Chemoimmunotherapy for Esophageal Squamous Cell Carcinoma

作者：Xufeng Guo, Chunji Chen, Jinbo Zhao, Changchun Wang, Xinyu Mei, Jianfei Shen, Huilai Lv, Yongtao Han, Qifeng Wang, Jiahua Lv, Hainan Chen, Xiaolong Yan, Zhichao Liu, Zhengyang Zhang, Qi-hong Zhong, Youhua Jiang, Liwei Xu, Xiaoyang Li, Dong Qian, Dehua Ma, Minhua Ye, Chunguo Wang, Zimin Wang, Jiangbo Lin, Ziqiang Tian, Xuefeng Leng, Zhigang Li · 发表于：JAMA Surgery · 年份：2025 · DOI：10.1001/jamasurg.2025.0220 · 被引用次数：69 · 研究领域：Esophageal Cancer Research and Treatment、Cancer Immunotherapy and Biomarkers、Head and Neck Cancer Studies

Importance: The association of neoadjuvant chemoimmunotherapy (NCIT) vs chemoradiotherapy (NCRT) with tumor downstaging and survival in locally advanced esophageal squamous cell carcinoma (ESCC) remains unclear because of limited evidence. Objective: To compare the associations of NCIT and NCRT with tumor regression and long-term survival in patients with locally advanced ESCC. Design, Setting, and Participants: In this comparative effectiveness research study, from January 2016 to March 2023, patients with locally advanced ESCC who underwent esophagectomy following NCRT or NCIT were identified from a prospective database of 8 high-volume esophageal surgery centers in China. Follow-up began on the date of surgery and continued until the last recorded contact or March 2024, whichever occurred first. Data were analyzed between April and September 2024. Main Outcomes and Measures: The primary end points were 2-year overall survival (OS) and disease-free survival (DFS). Secondary end points included major pathologic response (MPR) and pathologic complete response (pCR). Cox proportional hazard regression analysis was used to investigate the risk factors for OS and DFS. Results: The study included 1428 patients (median [IQR] age, 63 [57-68] years; 1184 men [82.9%]), with 704 patients in the NCRT group and 724 patients in the NCIT group. After propensity score matching, there were 532 patients in each group. The 2-year OS (81.3% vs 71.3%; hazard ratio, 1.57; 95% CI, 1.26-1.96; P < ...