We aimed to evaluate the efficacy of neoadjuvant docetaxel, cisplatin, and 5-fluorouracil (DCF) therapy over cisplatin, and 5-fluorouracil (CF) in patients with surgically resectable advanced esophageal squamous cell carcinoma (ESCC), using real-world data from 85 esophageal centers.
我们的目的是评估新辅助多西他赛、顺铂和5-氟尿嘧啶(DCF)相对于顺铂和5-氟尿嘧啶（CF）在可手术切除的晚期食管鳞癌(ESCC)患者中的疗效，我们使用了来自85个食管中心的真实世界数据。Summary Background Data: 背景资料总结
JCOG1109 trial, which assessed the superiority of DCF over CF, and the superiority of chemoradiotherapy with CF over CF alone demonstrated the significant survival advantage of neoadjuvant DCF in overall survival over CF for ESCC.
The ESCC patients who received neoadjuvant CF or DCF at 85 Japanese esophageal centers certified by Japan Esophageal Society were retrospectively reviewed. After propensity score (PS) matching, the overall survival (OS) and recurrence free survival (RFS) were compared bet ween CF and DCF.
We initially enrolled 4781 patients. After data cleaning and PS matching using pretreatment variables, 1074 patients for each group were selected for subsequent analysis. There was no significant difference in the incidence of postoperative pneumonia and anastomotic leakage. In the survival analysis, OS was significantly longer in DCF group than CF group (HR, 0.868; 95% CI, 0.770 –0.978; p=0.02), as well as RFS (HR, 0.850; 95% CI, 0.761–0.949; p=0.004). The survival advantage of DCF was not observed in patients with 76 years old or older.
我们最初入组了4781名患者。采用预处理变量进行数据清洗和PS匹配后，每组选取1074例患者进行后续分析。两组术后肺炎、吻合口漏发生率比较，差异无统计学意义。生存分析中，DCF组的OS明显长于CF组(HR, 0.868;95%可信区间，0.770 -0.978;p=0.02)， RFS (HR, 0.850;95%可信区间0.761 - 0.949;p = 0.004)。在76岁及以上的患者中没有观察到DCF的生存优势。
Neoadjuvant DCF therapy showed remarkable survival advantage in surgically resectable ESCC patients especially in patients who were 75 years old or younger. The current real-world evidence will encourage recommendations for DCF as a standard regimen in NAC based treatment strategy for ESCC.