Preoperative concurrent chemoradiotherapy has a good effect on patients with esophageal cancer

At present, the effect of preoperative concurrent chemoradiotherapy in the adjuvant treatment of esophageal cancer is quite significant in clinical practice.

First, chemoradiotherapy can take into account both the local tumor and possible micrometastases. Second, some chemotherapy drugs have radiosensitization effects. Using them at the same time can reduce the radiotherapy dose to reduce adverse reactions and improve treatment compliance and efficacy. For patients with locally advanced disease, preoperative chemoradiotherapy can shrink the tumor, reduce the stage, and increase the surgical resection rate, which is expected to improve long-term survival rate.

The results of a phase III clinical trial conducted by clinical scholars showed that the effect of concurrent preoperative chemoradiotherapy was comparable to that of preoperative chemotherapy. There was no difference in the surgical resection rate between the two groups, but the preoperative chemoradiotherapy group had a higher pathological complete remission rate and negative lymph node clearance rate, which were 15.6%:2.0% and 64.4%:37.7%, respectively. The 3-year survival rate of the preoperative chemoradiotherapy group increased from 27.7% to 47.4%. In another phase III clinical trial, it was found that preoperative chemoradiotherapy significantly increased the median survival time and 5-year survival rate of patients compared with surgery alone, which were 4.48:1.79 and 39%:16%, respectively.

The results of many meta-analyses in recent years have also confirmed that compared with surgical treatment alone, preoperative concurrent chemoradiotherapy + surgery can significantly prolong the patient's 1-, 2-, and 3-year survival rates, reduce the local recurrence rate, and reduce the risk of death, but it cannot reduce the incidence of postoperative complications.