137. THE COMPARISON OF SHORT-TERM OUTCOMES BETWEEN NEOADJUVANT CHEMOTHERAPY COMBINED WITH IMMUNOTHERAPY AND NEOADJUVANT CHEMORADIOTHERAPY FOR ESOPHAGEAL SQUAMOUS CANCER

Abstract

Abstract To evaluate the short-term outcomes of neoadjuvant chemotherapy combined with immunotherapy followed by esophagectomy for locally advanced esophageal squamous cell carcinoma. Patients receiving neoadjuvant chemotherapy combined with immunotherapy (NACI group) or chemoradiotherapy (NACR group) at our center between September 2019 and September 2021 were identified. The primary outcomes were tumor regression score (TRS), pathological complete regression (pCR), overall survival (OS), progression-free survival (PFS) and pathological downstaging. Secondary outcomes were toxic effects and postoperative complications. The propensity score matching for enrolled patients was performed. Data of 149 patients were analyzed. All included patients received minimally invasive esophagectomy, with only 3 conversion to open surgery. With regard toTRS, 25 (45.5%), 61 (64.9%) patients were scored 0 and 1 in the NACI and NACR groups, respectively (p = 0.020). Of note, 17 (30.9%) patients in the NACI group achieved pCR (ypT0N0), while 48 (51.1%) patients in NACR group achieved pCR (P = 0.026). Neoadjuvant chemoradiotherapy was associated with higher risk of postoperative pneumonia (p = 0.034). The 1-year cumulative progression-free survival rate was 85.4% and 75.4% in the NACI and NACR groups respectively (p = 0.147). We found that neoadjuvant immunotherapy combined with chemotherapy compared with neoadjuvant chemoradiotherapy was associated with lower pneumonia rate and was safe and feasible for locally advanced ESCC. However, the tumor regression score and the pathological complete response rate of patients treated with neoadjuvant immunotherapy was lower than those of patients treated with neoadjuvant chemoradiotherapy. The short-term follow-up results were comparable between two treatment modalities.