Neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy for the treatment of esophageal squamous cell carcinoma: a propensity score-matched study from the National Cancer Center in China

Zhang, Guochao; Zhang, Chaoqi; Sun, Nan; Xue, Liyan; Yang, Zhaoyang; Fang, Lingling; Zhang, Zhihui; Luo, Yuejun; Gao, Shugeng; Xue, Qi; Mu, Jianjun; Gao, Yushun; Tan, Fengwei

doi:10.1007/s00432-021-03659-7

Cited by 28 publications

(29 citation statements)

References 34 publications

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“…A recent meta-analysis including 4,529 patients (nCT 2,035 and nCRT 2,494) showed that compared with nCT, nCRT could provide a higher 3-year survival benefit, higher R0 resection, and pCR rates, but no increase in 5-year survival (24). Zhang et al conducted a propensity score-matched study from the National Cancer Center to compare the long-term results between nCRT and nCT and found that significantly higher pCR rates in the nCRT group did not lead to a longer survival (25). Thus, considering the different mechanisms of immunotherapy, it is worth conducting a long-term follow-up to evaluate the effect of nICT.…”

Section: Discussionmentioning

confidence: 99%

“…Zhang et al. conducted a propensity score-matched study from the National Cancer Center to compare the long-term results between nCRT and nCT and found that significantly higher pCR rates in the nCRT group did not lead to a longer survival ( 25 ). Thus, considering the different mechanisms of immunotherapy, it is worth conducting a long-term follow-up to evaluate the effect of nICT.…”

Section: Discussionmentioning

confidence: 99%

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Safety and Feasibility of Esophagectomy Following Combined Immunotherapy and Chemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score Matching Analysis

et al. 2022

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ObjectivesThe combination of neoadjuvant chemotherapy and immunotherapy (nICT) is a novel treatment for locally advanced esophageal cancer. There is concern that nICT may increase operation difficulty, postoperative morbidity, and mortality. This study aimed to compare short-term outcomes among esophagectomy after neoadjuvant chemoradiotherapy (nCRT) and nICT and for locally advanced esophageal squamous cell carcinoma (ESCC).MethodsA retrospective analysis of a prospectively maintained database was performed to identify patients (from January 2017 through July 2021) who underwent surgery for ESCC following neoadjuvant therapy. A 1:1 propensity score matching (PSM) with a caliper 0.05 was conducted to balance potential bias.ResultsA 1:1 PSM was conducted based on clinical stage, age, body mass index (BMI), and tumor location, and then 32 comparable pairs were matched. After PSM, age, gender, BMI, American Society of Anesthesiologists (ASA) status, smoking history, clinical stage, tumor location, lymphadenectomy field, pathological stage, anastomotic position, route of gastric conduit, procedure type, and operative approach were comparable between groups. Compared with the nICT group (median, 300 min), the operation time was significantly longer in the nCRT group (median, 376 min). However, both groups were comparable in intraoperative blood loss, thoracic drainage volume, intensive care unit (ICU) stay, postoperative hospital stays, and hospital cost. Further, 30-day mortality, 30-day readmission, ICU readmission, and major complications were similar in both groups. The nCRT group had an advantage in pathological response. The pathological complete response (pCR) was 18.8% (6/32) in the nICT group and 43.8% (14/32) in the nCRT group (p = 0.03). The major pathological response (MPR) was 71.9% (23/32) in the nCRT group and 34.4% (11/32) in the nICT group (p = 0.03).ConclusionsBased on our preliminary experience, esophagectomy appears to be safe and feasible following combined neoadjuvant immunotherapy with chemotherapy for locally advanced esophageal cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety and Feasibility of Esophagectomy Following Combined Immunotherapy and Chemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score Matching Analysis

et al. 2022

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“…We excluded 497 irrelevant research studies, 102 studies that studied NCRT combined with surgery vs surgery alone, 21 studies that studied CRT combined with surgery vs surgery alone, 5 studies that met the inclusion criteria that were in progress, 21 studies that included EAC and 4 studies that had inconsistent outcome indicators. Finally, 18 studies were included in the meta-analysis, of which seven [19][20][21][22][23][24][25] were randomized trials and eleven [26][27][28][29][30][31][32][33][34][35][36] were retrospective studies. The flow chart of the literature screening process is shown in Fig 1 . A total of 2042 patients were included in the NCRT group, and 1095 patients were included in the NCT group.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Ten included studies reported R0 resection [20,22,23,25,26,28,29,32,35,36]. There was no significant heterogeneity between studies (p = 0.33, I 2 = 12%); therefore, the fixed-effects model was used for the meta-analysis.…”

Section: R0 Resectionmentioning

confidence: 99%

“…Ten studies reported perioperative mortality [22,23,25,26,28,29,[32][33][34][35], ten studies reported anastomotic leak [20-22, 25, 26, 28, 29, 32, 33, 35], eight studies reported pulmonary complications [21,25,26,28,29,32,33,35], five studies reported cardiac complications [21,26,28,29,35], four studies reported chyle leak [21,22,26,35], four studies reported stricture [20,22,28,35], three studies reported postoperative vocal cord paralysis [21,26,35], three studies reported postoperative bleeding [20,22,26], and two studies reported postoperative infection [26,35]. No heterogeneity was found for any complication; therefore, a fixed-effects model was used for analysis.…”

Section: Postoperative Complicationsmentioning

confidence: 99%

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Survival and complications after neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy for esophageal squamous cell cancer: A meta-analysis

Guo

Lou

et al. 2022

PLoS ONE

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Objectives To compare the survival and complications of neoadjuvant chemoradiation (NCRT) versus neoadjuvant chemotherapy (NCT) for esophageal squamous cell carcinoma (ESCC). Methods We conducted a systematic literature search of the PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, Wanfang Data, CBM, and VIP databases from inception to November 2021. Meta-analyses were performed using RevMan (version 5.3) and Stata version 15.0. Results A total of 18 studies were included, which involved 3137 patients, The results of the metaanalysis showed that the pathological complete remission rate (odds ratio [OR] = 5.21, 95% confidence interval [CI]: 2.85–9.50, p<0.00001) and complete tumor resection rate (OR = 2.31, 95% CI: 1.57–3.41, p<0.0001) in the NCRT group were significantly better than those in the NCT group. Our meta-analysis results showed that 1-, 3-, and 5-year survival rates (1-year overall survival [OS]: OR = 1.51, 95% CI: 1.11–2.05, p = 0.009; 3-year OS: OR = 1.73, 95% CI: 1.36–2.21, p<0.0001; 5-year OS: OR = 1.61, 95% CI: 1.30–1.99, p<0.00001) in the NCRT group were significantly higher than those in the NCT group. NCRT can lead a significant survival benefit compared with NCT and there was no significant difference between the two neoadjuvant treatments in terms of postoperative complications. Conclusion The use of NCRT in the treatment of patients with ESCC patients showed significant advantages in terms of survival and safety relative to the use of NCT.

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Self‐Assembled Acid‐Responsive Nanosystem for Synergistic Anti‐Angiogenic/Photothermal/Ferroptosis Therapy against Esophageal Cancer

Li,

et al. 2023

Adv Healthcare Materials

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Esophageal cancer (EC) treatment via anti‐angiogenic therapy faces challenges due to non‐cytotoxicity and non‐specific biodistribution of the anti‐angiogenic agents. Hence, the quest for a synergistic treatment modality and a targeted delivery approach to effectively address EC has become imperative. In this study, an acid‐responsive release nanosystem (Bev‐IR820@FeIIITA) that involves the conjugation of bevacizumab, an anti‐angiogenic monoclonal antibody, with TA and Fe3+ to form a metal‐phenolic network, followed by loading with the near‐infrared photothermal agent (IR820) to achieve combinational therapy, is designed. The construction of Bev‐IR820@FeIIITA can be realized through a facile self‐assembly process. The Bev‐IR820@FeIIITA exhibits tumor‐targeting capabilities and synergistic therapeutic effects, encompassing anti‐angiogenic therapy, photothermal therapy (PTT), and ferroptosis therapy (FT). Bev‐IR820@FeIIITA exhibits remarkable proficiency in delivering drugs to EC tissue through its pH‐responsive release properties. Consequently, bevacizumab exerts its therapeutic effects by obstructing tumor angiogenesis, thereby impeding tumor growth. Meanwhile, PTT facilitates localized thermal ablation at the tumor site, directly eradicating EC cells. FT synergistically collaborates with PTT, giving rise to the formation of a reactive oxygen species (ROS) storm, subsequently culminating in the demise of EC cells. In summary, this amalgamated treatment modality carries substantial promise for synergistically impeding EC progression and showcases auspicious prospects for future EC treatment.

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Neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy for the treatment of esophageal squamous cell carcinoma: a propensity score-matched study from the National Cancer Center in China

Cited by 28 publications

References 34 publications

Safety and Feasibility of Esophagectomy Following Combined Immunotherapy and Chemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score Matching Analysis

Safety and Feasibility of Esophagectomy Following Combined Immunotherapy and Chemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score Matching Analysis

Survival and complications after neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy for esophageal squamous cell cancer: A meta-analysis

Self‐Assembled Acid‐Responsive Nanosystem for Synergistic Anti‐Angiogenic/Photothermal/Ferroptosis Therapy against Esophageal Cancer

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