Neoadjuvant Arterial Infusion Chemotherapy Combined With Immunotherapy in Treating Locally Advanced Lower Esophageal /Esophagogastric Junction Cancer

Abstract

Background: To retrospectively analyze the safety and efficacy of neoadjuvant arterial infusion chemotherapy combined with immunotherapy (neo-AICIT) in treating locally advanced lower esophageal cancer/esophagogastric junction cancers. Methods: The data of patients who received neoadjuvant arterial infusion chemotherapy (docetaxel + cisplatin) combined with immunotherapy (tislelizumab) for locally advanced lower esophageal cancer or esophagogastric junction cancers from October 2021 to June 2022 were collected. The indicators of these patients, such as the clinical staging of tumors, complications of the interventional operation, treatment-related adverse events (TRAEs), the effect of neoadjuvant therapy, operative complications, tumor regression grade (TRG), progression free survival (PFS) and follow-up time, were recorded. Results: A total of 7 patients received a complete neoadjuvant regimen, sequential surgery and postoperative maintenance immunotherapy. The median age was 68. All patients suffered from squamous cell carcinoma; 5 of them had lower esophageal cancer and 2 had esophagogastric junction cancer. The clinical staging in all patients was cT3N0-2M0G1-3. Except for low fever in 1 patient, no other complications of interventional operation occurred. The incidence of grade 1 treatment-related adverse events during the adjuvant therapy was 57.1% (4/7). The postoperative pathology showed that 4 (57.1%, 4/7) patients had pathological complete response (pCR) with a TRG of 3; and 3 (42.9%, 3/7) patients had major pathological remission (MPR) with a TRGof 2. The objective response rate (ORR) was 100%. The median follow-up time was 19 months. Mediastinal group 4 lymph node metastasis was found in 1 patient 18 months after the operation. Tumor recurrence or metastasis was not found in other patients. Conclusion: neo-AICIT has good safety and efficacy in treating locally advanced lower esophageal cancer/esophagogastric junction cancers and may be a promising neoadjuvant therapy.