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Retrospective analysis of neoadjuvant chemotherapy followed by surgery versus definitive chemoradiotherapy with proton beam for locally advanced esophageal squamous cell carcinoma

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Abstract

Background

This is the first study to compare the long-term outcomes between neoadjuvant chemotherapy + surgery and definitive chemoradiotherapy with proton beam therapy for locally advanced esophageal squamous cell carcinoma.

Methods

We reviewed patients with clinical stage IB–III esophageal squamous cell carcinoma (UICC 7th edition) who underwent neoadjuvant chemotherapy + surgery or definitive chemoradiotherapy with proton beam therapy (2009–2017). Overall survival, progression-free survival, and recurrence or regrowth rates were compared between the two treatment groups. Subgroup analyses of overall survival according to baseline characteristics were also performed.

Results

Forty-three patients received neoadjuvant chemotherapy + surgery (median follow-up 47.4 months) and 60 received definitive chemoradiotherapy with proton beam therapy (median follow-up 51.5 months). Baseline characteristics were similar between the groups except for sex, tumor location, and cT classification. The neoadjuvant chemotherapy + surgery and definitive chemoradiotherapy with proton beam therapy groups had similar 3-year overall survival rates (73.1% and 61.7%, respectively, hazard ratio: 0.88, 95% confidence interval 0.49–1.58, p = 0.66), 3-year progression-free survival rates (46.5% and 45%, respectively, hazard ratio: 1.03, 95% confidence interval 0.62–1.70, p = 0.92), and recurrence or regrowth rates (53.5% vs. 50.0%, p = 0.84). In the subgroup analysis, favorable survival was observed after definitive chemoradiotherapy with proton beam therapy for cT1–2 disease (hazard ratio 2.58, 95% confidence interval 0.84–7.99) and after neoadjuvant chemotherapy + surgery for cT3 or higher disease (hazard ratio 0.32, 95% confidence interval 0.15–0.67, p-for-interaction = 0.002).

Conclusions

Long-term outcomes were comparable between the treatments. The choice of the treatment according to cT classification might affect survival.

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Acknowledgements

This study was approved by T-CReDO (Tsukuba Clinical Research & Development Organization).

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Authors and Affiliations

  1. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305–8575, Japan

    Koichi Ogawa, Katsuji Hisakura, Yoshimasa Akashi, Yohei Owada, Yusuke Ohara, Tsuyoshi Enomoto, Kinji Furuya, Manami Doi, Osamu Shimomura, Kazuhiro Takahashi, Shinji Hashimoto & Tatsuya Oda

  2. Department of Radiation Oncology, National Institutes for Quantum and Radiological Science and Technology, QST Hospital, Chiba, Japan

    Hitoshi Ishikawa

  3. Department of Radiation Oncology and Proton Medical Research Center, University of Tsukuba, Ibaraki, Japan

    Hitoshi Ishikawa, Yuichi Hiroshima & Hideyuki Sakurai

  4. Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan

    Toshikazu Moriwaki, Takeshi Yamada & Yoshiyuki Yamamoto

Authors
  1. Koichi Ogawa
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  2. Hitoshi Ishikawa
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  18. Tatsuya Oda
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Corresponding author

Correspondence to Koichi Ogawa.

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Ogawa, K., Ishikawa, H., Hisakura, K. et al. Retrospective analysis of neoadjuvant chemotherapy followed by surgery versus definitive chemoradiotherapy with proton beam for locally advanced esophageal squamous cell carcinoma. Int J Clin Oncol 26, 1856–1863 (2021). https://doi.org/10.1007/s10147-021-01981-1

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  • DOI: https://doi.org/10.1007/s10147-021-01981-1

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