Neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy followed by minimally invasive esophagectomy for locally advanced esophageal squamous cell carcinoma: a prospective multicenter randomized clinical trial

• DOI: 10.1016/j.annonc.2022.10.508
• Publication Date: 2022-11-16T02:31:59Z
• Authors: H. Tang; H. Wang; Y. Fang; J.Y. Zhu; J. Yin; Y.X. Shen; Z.C. Zeng; D.X. Jiang; Y.Y. Hou; M. Du; C.H. Lian; Q. Zhao; H.J. Jiang; L. Gong; Z.G. Li; J. Liu; D.Y. Xie; W.F. Li; C. Chen; B. Zheng; K.N. Chen; L. Dai; Y.D. Liao; K. Li; H.C. Li; N.Q. Zhao; L.J. Tan
• Keywords: Interquartile range; Esophagectomy; Neoadjuvant Therapy; Chemoradiotherapy; Clinical endpoint

•The CMISG1701 trial assessed the safety and efficacy of nCRT versus nCT followed by MIE for locally advanced bulky ESCC.•The strategy could not improve survival significantly compared with strategy.•The best neoadjuvant therapy ESCC remains a pending issue. BackgroundNeoadjuvant is recommended esophageal cancer, but optimal unclear. We aimed to evaluate chemoradiotherapy (nCRT) chemotherapy (nCT) minimally invasive esophagectomy (MIE) squamous cell carcinoma (ESCC).Patients methodsEligible patients staged as cT3-4aN0-1M0 were randomly assigned (1 : 1) or group stratified age, cN stage, centers. The chemotherapy, based on paclitaxel cisplatin, was administered both groups, while concurrent radiotherapy added group; then carried out. primary endpoint 3-year overall survival. This study registered ClinicalTrials.gov (NCT03001596).ResultsA total 264 eligible intention-to-treat analysis. By 30 November 2021, 121 deaths had occurred. median follow-up 43.9 months (interquartile range 36.6-49.3 months). in population comparable between strategies [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.58-1.18; P = 0.28], rate 64.1% (95% CI 56.4% 72.9%) 54.9% 47.0% 64.2%), respectively. There also no differences progression-free (HR 0.83, 0.59-1.16; 0.27) recurrence-free 1.07, 0.71-1.60; 0.75), although pathological complete response (31/112, 27.7%) higher than that (3/104, 2.9%; < 0.001). Besides, trend lower risk recurrence observed (P 0.063), pattern similar 0.802).ConclusionsNCRT associated better among ESCC. results underscore issue Neoadjuvant (ESCC). Eligible (NCT03001596). A 0.802). NCRT