{"title":"Neoadjuvant chemoimmunotherapy versus neoadjuvant chemoradioimmunotherapy for locally advanced esophageal squamous cell carcinoma.","authors":"Liqiang Shi, Yingyi Li, Chengqiang Li, Xipeng Wang, Qingchun Cai, Yuqin Cao, Fei Teng, Fei Liao, Hecheng Li, Zhiqiang Wang","doi":"10.1007/s10147-026-03093-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Comparative evidence for neoadjuvant chemoimmunotherapy (NCIT) versus neoadjuvant immunotherapy combined with chemoradiotherapy (NICRT) in locally advanced esophageal squamous cell carcinoma (ESCC) is limited. We compared pathological response and survival outcomes between these two strategies.</p><p><strong>Methods: </strong>We retrospectively analyzed ESCC patients who received NCIT or NICRT followed by surgery between February 2019 and March 2025 at two centers. Pathological response, 2-year overall survival (OS), and disease-free survival (DFS) were compared between groups. Survival was estimated using the Kaplan-Meier method and compared with the log-rank test. Propensity score matching (PSM) was applied to adjust for baseline imbalances.</p><p><strong>Results: </strong>Among 212 patients, 110 received NICRT and 102 received NCIT. After PSM, NICRT yielded higher rates of major pathological response (MPR) (77.3% vs. 41.3%; p < 0.001) and pathological complete response (pCR) rates (46.7% vs. 22.7%; p = 0.004) compared with the NCIT. Lymph node yield was significantly higher in the NCIT group than in the NICRT group. (median: 21 vs. 17; p = 0.008). Besides, the perioperative safety and recurrence patterns were comparable between groups. However, 2-year OS (82.6% vs. 87.3%) and DFS (71.4% vs.79.0%) did not differ significantly between NICRT and NCIT groups.</p><p><strong>Conclusions: </strong>NICRT achieved superior pathological responses but did not improve 2-year survival compared with NCIT. Perioperative safety and recurrence patterns were similar between regimens. Prospective randomized controlled trials are needed to validate these findings.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1879-1889"},"PeriodicalIF":3.0000,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10147-026-03093-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/6/11 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Comparative evidence for neoadjuvant chemoimmunotherapy (NCIT) versus neoadjuvant immunotherapy combined with chemoradiotherapy (NICRT) in locally advanced esophageal squamous cell carcinoma (ESCC) is limited. We compared pathological response and survival outcomes between these two strategies.
Methods: We retrospectively analyzed ESCC patients who received NCIT or NICRT followed by surgery between February 2019 and March 2025 at two centers. Pathological response, 2-year overall survival (OS), and disease-free survival (DFS) were compared between groups. Survival was estimated using the Kaplan-Meier method and compared with the log-rank test. Propensity score matching (PSM) was applied to adjust for baseline imbalances.
Results: Among 212 patients, 110 received NICRT and 102 received NCIT. After PSM, NICRT yielded higher rates of major pathological response (MPR) (77.3% vs. 41.3%; p < 0.001) and pathological complete response (pCR) rates (46.7% vs. 22.7%; p = 0.004) compared with the NCIT. Lymph node yield was significantly higher in the NCIT group than in the NICRT group. (median: 21 vs. 17; p = 0.008). Besides, the perioperative safety and recurrence patterns were comparable between groups. However, 2-year OS (82.6% vs. 87.3%) and DFS (71.4% vs.79.0%) did not differ significantly between NICRT and NCIT groups.
Conclusions: NICRT achieved superior pathological responses but did not improve 2-year survival compared with NCIT. Perioperative safety and recurrence patterns were similar between regimens. Prospective randomized controlled trials are needed to validate these findings.
背景：新辅助化疗免疫治疗（NCIT）与新辅助免疫治疗联合放化疗（NICRT）治疗局部晚期食管鳞状细胞癌（ESCC）的比较证据有限。我们比较了这两种策略的病理反应和生存结果。方法：我们回顾性分析了2019年2月至2025年3月在两个中心接受NCIT或NICRT术后的ESCC患者。比较两组间病理反应、2年总生存期（OS）和无病生存期（DFS）。生存率采用Kaplan-Meier法估计，并与log-rank检验进行比较。倾向评分匹配（PSM）用于调整基线失衡。结果：212例患者中110例接受NICRT治疗，102例接受NCIT治疗。PSM后，NICRT产生了更高的主要病理反应（MPR）率（77.3% vs. 41.3%）； p结论：与NCIT相比，NICRT获得了更好的病理反应，但没有提高2年生存率。两种方案的围手术期安全性和复发模式相似。需要前瞻性随机对照试验来验证这些发现。
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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