OA01.2. Clinical Outcomes of Neoadjuvant Chemoimmunotherapy Versus Chemoradiation Combined With Immunotherapy in Locally Advanced ESCC: A Propensity Score-Matched Analysis

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ID: 325923
2026
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Ranked #403 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Esophageal Cancer: Adjuvant and Neo-Adjuvant Therapies Background Neoadjuvant chemoimmunotherapy (NCIT) has emerged as a promising strategy, in patients with esophageal squamous cell carcinoma (ESCC). However, whether neoadjuvant chemoradiation-immunotherapy (NCRI) can further improve therapeutic efficacy remains uncertain. Methods We prospectively enrolled and retrospectively analyzed 557 consecutive patients with locally advanced ESCC who underwent neoadjuvant therapy between December 2019 and January 2025. Participants were stratified into two treatment cohorts: those receiving NCIT and those undergoing NCRI. To mitigate potential selection bias and ensure balanced baseline characteristics between groups, we implemented a 1:1 propensity score matching (PSM) protocol incorporating multiple clinically relevant covariates to assess short-term pathological outcomes and long-term survival. Results There were significant differences in age and immunotherapy regimens between the NCIT and NCRI groups before matching. After PSM, these baseline characteristics were well balanced, with 124 patients in each group. The NCRI group demonstrated superior pathological outcomes, including higher pathological complete response (pCR) rate (41.1% vs 19.4%, P<0.001) and lower TRS (p<0.001). However, no significant differences were observed in overall survival (OS) (P=0.837) or disease-free survival (DFS) (P=0.429) between the two groups during follow-up. Conclusion The addition of radiotherapy to NCIT significantly improved pCR rates compared to NCIT alone. However, this pathological benefit did not translate into superior long-term survival outcomes in both OS and DFS. Prospective randomized trials are warranted to validate these findings and further elucidate the role of radiotherapy in NCIT for ESCC.
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Authors Pinhao Fang
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.007
URL
https://academic.oup.com/dote/article-pdf/39/Supplement_1/doag077.007/70760450/doag077.007.pdf
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