UNASSIGNED: Retrospective analysis was conducted on patients with unresectable cT4b stage ESCC who underwent conversion surgery in our hospital from January 2020 to December 2022. According to the preoperative induction treatment plan, they were divided into induction immunochemotherapy group (iICT group) and induction chemotherapy group (iCT group). The conversion surgery rate, R0 resection rate, radiological and pathological tumor responses, safety, and short-term survival outcomes were analyzed.
UNASSIGNED: The results showed that a total of 199 patients with cT4b locally advanced unresectable ESCC who underwent preoperative induction therapy were included in this study. Among them, there were 64 cases (32.2%) in the iICT group, 135 cases (67.8%) in the iCT group. There was a statistically significant difference in objective response rate (73.5% vs 48.9%) and conversion surgery rate (81.3% vs 66.7%), between the iICT and iCT groups (P=0.001 and P=0.019). Among the two groups of patients who underwent surgery, there were statistically significant differences in R0 resection rate (94.2% vs 82.2%) and pathological complete remission rate (23.1% vs 6.7%) between the iICT and iCT groups (P=0.043 and P=0.004). And there was no statistically significant difference in the incidence of grade 3 and above between two groups (P=0.928). The 2-year EFS of the iICT group and iCT group were 76.4% and 42.4%, respectively, with statistically significant differences (P=0.006).
UNASSIGNED: Compared with simple chemotherapy, the combination of PD-1 inhibitors and chemotherapy can achieve better conversion surgery rate, tumor response and event-free survival in the conversion therapy of locally advanced unresectable ESCC.
■对2020年1月至2022年12月在我院接受转换手术的不可切除的cT4b期ESCC患者进行了回顾性分析。根据术前诱导治疗计划,分为诱导化疗组(iICT组)和诱导化疗组(iCT组).转换手术率,R0切除率,放射学和病理学肿瘤反应,安全,并对短期生存结局进行分析.
■结果显示,共有199例接受术前诱导治疗的cT4b局部晚期不可切除的ESCC患者被纳入本研究。其中,iICT组有64例(32.2%),iCT组135例(67.8%)。客观缓解率(73.5%vs48.9%)和转换手术率(81.3%vs66.7%)有统计学意义的差异,iICT组和iCT组之间(P=0.001和P=0.019)。在接受手术治疗的两组患者中,iICT组和iCT组的R0切除率(94.2%vs82.2%)和病理完全缓解率(23.1%vs6.7%)差异有统计学意义(P=0.043和P=0.004)。3级及以上发生率两组间差异无统计学意义(P=0.928)。iICT组和iCT组的2年EFS分别为76.4%和42.4%,分别,差异具有统计学意义(P=0.006)。
■与单纯化疗相比,PD-1抑制剂与化疗联合使用可以获得更好的中转手术率,局部晚期不可切除的ESCC的转换治疗中的肿瘤反应和无事件生存期.