One-day preoperative systemic treatment regimen outcompetes five-day regimen in potentially resectable esophageal squamous cancer

ObjectiveThe current study aimed to compare the effectiveness of the one-day immunochemotherapy regimen, the one-day chemotherapy regimen and the five-day chemotherapy regimen in locally advanced esophageal squamous cell carcinoma patients treated with preoperative systemic treatment. MethodsWe retrospectively analyzed locally advanced ESCC patients who had received POST from January 2012 to September 2021 at the Department of Thoracic Surgery, Guangdong Provincial Peoples Hospital. The clinical and follow-up data were collected and analyzed according to 3 regimens. Categorical and continuous variables were analyzed by Chi-square and One-way ANOVA respectively, and overall survival (OS) was assessed using Kaplan-Meier analysis. ResultsA total of 395 POST-treated ESCC patients were enrolled, including 72 in the 5FU-based group, 168 in the pla/pac group, and 155 in the pla/pac/ICI group, and the mean follow-up time were 32.2, 44.2 and 14.3 months, respectively. the pla/pac/ICI group had the greatest benefit, with an ORR of 63.2% (P < 0.05) and a surgery conversion rate of 85.2% (P < 0.05). Furthermore, pla/pac/ICI group acquired a better short-term OS than the other groups (one-year OS: pla/pac/ICI 93.6% vs. pla/pac 87.4% vs. 5FU-based 70.5%). ConclusionIn the context of the COVID-19 pandemic, one-day immunochemotherapy should be considered because it may yield higher response rates, bring better overall survival as well as greatly reduce the risk of treatment interruption. If immunotherapy is not available, the 1-day pla/pac regimen is also an effective and timely alternative.