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Updated: Aug 14, 2026
Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019
Neoadjuvant chemoradiotherapy versus immunochemotherapy in esophageal squamous cell carcinoma: a propensity-matched
Zhou Yehan1, Xiaoqing Zhou1, Shangzhi Hu2
1Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
Objective:
To compare efficacy, survival and tumor immune microenvironment between neoadjuvant chemoradiotherapy (NCRT) and neoadjuvant immunochemotherapy (NICT) in patients with esophageal squamous cell carcinoma (ESCC) to guide individualized treatment.
Methods:
A total of 346 locally advanced ESCC patients after 1:1 propensity score matching were retrospectively analyzed. Pathological, radiological and multiplex immunofluorescence assessments were performed, and survival outcomes were evaluated.
Results:
NCRT resulted in significantly greater tumor volume reduction (22.09 vs. 15.37 mm³), lower residual primary tumor ratio (14.10% vs. 32.23%), higher tumor downstaging and pathological complete response (pCR) rates (all p < 0.05). NCRT showed more prominent lymph node regression adjacent to the primary tumor than in peripheral nodes. Overall survival (OS) and recurrence-free survival (RFS) were comparable between groups. Among pCR patients, NICT achieved significantly better OS (p = 0.0051) and RFS (p = 0.018), while NCRT was associated with superior RFS in non-pCR patients (p = 0.0099). In the NICT group, high PD-L1 expression and low tumor burden tended to correlate with pCR. Immune microenvironment analysis revealed fewer immunosuppressive T cells and immune-evasive tumor cells in the NICT group.
Conclusion:
NCRT presents superior local tumor regression, while NICT benefits pCR patients by optimizing the immune microenvironment. High PD-L1 expression and low tumor burden favor NICT. These findings support individualized neoadjuvant strategy selection for ESCC.
