Comparison of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy in treating locally advanced esophageal squamous cell carcinoma

Abstract

Objective To compare the efficacy of neoadjuvant chemoradiotherapy (NCRT) and neoadjuvant chemotherapy (NCT) in treating locally advanced esophageal squamous cell carcinoma. Methods We retrospectively analyzed a total of 177 patients who received NCRT (72 patients) or NCT (105 patients) combined with surgery for esophageal squamous cell carcinoma from January 2009 to October 2015 in the Affiliated Cancer Hospital of Zhengzhou University. The survival rate was analyzed using the Kaplan-Meier method. Results Among the 177 patients (clinical stage cT2-4N0-1M0), the 2-and 3-year sample sizes were 44 and 26 in the NCRT group, and 47 and 28 in the NCT group. The pathological complete response (pCR) rate was significantly higher in the NCRT group than in the NCT group (22% vs. 10%, P=0.019). There were no significant differences in the incidence of postoperative complications, mortality, and recurrence rate between the two groups (all P>0.05). The 2-and 3-year overall survival rates for the NCRT group were 74% and 51%, versus 64% and 51% for the NCT group (P=0.527); the 2-and 3-year disease-free survival rates for the NCRT group were 54% and 50%, versus 54% and 46% for the NCT group (P=0.379). Conclusions Compared with NCT, NCRT significantly increases the pCR rate without increasing postoperative complications and mortality in esophageal squamous cell carcinoma patients. However, since the survival rate is similar between the two groups, the efficacy of NCRT and NCT remains to be verified by further prospective, multi-centered, and large-sample studies. Key words: Esophageal neoplasms/chemotherapy; Esophageal neoplasms/chemoraidotherapy; Adjuvant chemoradiotherapy; Prognosis