153. PROPENSITY MATCHING ANALYSIS OF NEOADJUVANT CHEMORADIOTHERAPY AND NEOADJUVANT IMMUNOTHERAPY COMBINED WITH CHEMOTHERAPY IN THE TREATMENT OF LOCALLY ADVANCED ESCC

Abstract Background The combination of neoadjuvant chemoradiotherapy (NCR) with surgical resection remains the standard treatment option for locally advanced esophageal squamous cell carcinoma (ESCC). Chemotherapy combined with immunotherapy has become a first-line treatment option for advanced and metastatic ESCC. The study of neoadjuvant chemotherapy combined with immunotherapy (NCI) in locally advanced ESCC is in full swing, and its effectiveness and safety need further study. Methods The data of patients with locally advanced ESCC who underwent neoadjuvant therapy combined with surgery in our hospital from 2014 to 2022 were included, and a retrospective control study was carried out. The perioperative and pathological results of patients in the NCI group and NCR group were analyzed by 1:1 propensity score matching to determine the effectiveness and safety of NCI. Result A total of 214 patients were included in the study, including 136 patients with NCR and 78 patients with NCI. After 1:1 propensity score matching, 66 patients in each group were included in the final analysis. There was no significant difference in baseline characteristics, including age, gender, smoking and drinking history, comorbidity, cT stage, cN stage, cTNM stage, etc. The pathological results showed that the pCR rate of the NCR group was 27.3% (18/66), while the pCR rate of the NCI group was 25.8% (20/57), with no statistical difference (p > 0.05). The interval between neoadjuvant therapy and surgery in the NCR group was 47.1 ± 13.2 days, significantly longer than that of 34.7 ± 8.8 days in the NCI group (p < 0.001). There was no significant difference in the overall postoperative complications, pneumonia, and anastomotic leakage rates between the two groups of patients. Conclusion The results of this study indicate that there is no significant difference in the incidence of perioperative complications and pathological response between NCI and NCR group. As a new treatment option, the efficacy and safety of NCI are not inferior to NCR, but prospective randomized controlled studies are still needed to verify our results.