Neoadjuvant Chemotherapy Versus Chemoradiotherapy for Patients with Esophageal Squamous Cell Carcinoma

Abstract

Aim: To confirm the superiority of neoadjuvant chemoradiotherapy (NACRT) over neoadjuvant chemotherapy (NAC) as preoperative therapy for locally advanced esophageal cancer.

Patients and methods: A total of 298 patients with resectable esophageal cancer were initially enrolled; 62 patients received NAC and 236 patients received NACRT. Propensity score matching was applied to create a study cohort.

Results: Postoperative 30-day mortality rate, overall postoperative complication rate, and overall survival time did not differ between those groups. Complete pathological response occurred in one patient treated with NAC and 16 treated with NACRT (p<0.001). In patients with borderline-resectable T4 disease, overall survival was superior in the NACRT group compared to that in the NAC group (p=0.040).

Conclusion: No survival advantage was observed between NAC and NACRT groups. Limited to patients with borderline-resectable T4, NACRT achieved a higher rate of primary tumor volume reduction and R0 resection, and a more favorable prognosis compared to NAC.

Keywords: Esophageal squamous cell carcinoma; neoadjuvant chemoradiotherapy; neoadjuvant chemotherapy.