Chemoradiotherapy Results Without Surgery in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma

INTRODUCTION: It aimed to evaluate the overall survival (OS) results of chemoradiotherapy (CRT) without surgery in patients with locally advanced esophageal squamous cell carcinoma (ESCC).
METHODS: Patients who received chemoradiotherapy with a diagnosis of ESCC at the Radiation Oncology Department of Ankara Bilkent City Hospitals were retrospectively analysed. The primary endpoint was OS.
RESULTS: The results of 46 patients who underwent radiotherapy (RT) between 26.06.2012 and 21.03.2023 were analysed. Median follow-up was 14 (range 1-47) months. The localisation was upper thoracic in 8(17.4%), middle thoracic in 36(78.3%) and lower thoracic in 2(4.3%) patients. Surgery was considered at the time of admission to the radiotherapy clinic in 25 (54.3%) of our patient group, and neoadjuvant treatment was given, but no surgery was subsequently performed. Patients referred to the radiotherapy clinic for neoadjuvant chemoradiotherapy received a significantly lower total dose than those referred directly for definitive chemoradiotherapy (p0.006; Z-2.768). Patients were evaluated by endoscopic biopsy and computed tomography 6-8 weeks after the end of treatment, and clinical complete response (cCR) was observed in 15 (32.6%) patients. At last follow-up, 19 (41.3%) patients were dead and 27 (58.7%) were alive. Median OS was 25 months (range 1.5-47). 1-year OS was 66%; 2-year OS was 54.7%; 3-year OS was 40.4%. Significantly higher OS was observed in patients with cCR (HR 4.2; 95% CI 1.2-14.7).
DISCUSSION AND CONCLUSION: Patients referred to the radiotherapy clinic for neoadjuvant therapy received a significantly lower total dose than patients referred for definitive chemoradiotherapy. Patients who received cCR after chemoradiotherapy had significantly higher OS.