Preoperative radiotherapy in patients with locally advanced esophageal squamous cell carcinoma: a narrative review
Neoadjuvant treatments play a crucial role in improving survival rates for patients with locally advanced resectable esophageal cancer. The CROSS and NEOCRTEC5010 trials have shown that neoadjuvant concurrent chemoradiotherapy significantly enhances survival compared to surgery alone. In contrast, t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1613954/full |
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| author | Yan Lin Shou-Feng Wang Huan-Wei Liang Yang Liu Wei Huang Xin-Bin Pan |
| author_facet | Yan Lin Shou-Feng Wang Huan-Wei Liang Yang Liu Wei Huang Xin-Bin Pan |
| author_sort | Yan Lin |
| collection | DOAJ |
| description | Neoadjuvant treatments play a crucial role in improving survival rates for patients with locally advanced resectable esophageal cancer. The CROSS and NEOCRTEC5010 trials have shown that neoadjuvant concurrent chemoradiotherapy significantly enhances survival compared to surgery alone. In contrast, the NeoRes and CMISG1701 trials indicate that while neoadjuvant chemoradiotherapy yields a higher histological complete response rate, it does not confer survival benefits over neoadjuvant chemotherapy. The recent JCOG1109 trial has demonstrated that neoadjuvant triplet chemotherapy offers a statistically significant overall survival advantage compared to doublet chemotherapy. However, combining doublet chemotherapy with radiotherapy did not show notable survival improvement compared to doublet chemotherapy alone. Additionally, neoadjuvant immunotherapy in conjunction with chemotherapy has shown a greater histological complete response rate compared to neoadjuvant chemotherapy, with comparable rates to neoadjuvant chemoradiotherapy. These findings have sparked debate regarding the necessity of radiotherapy in neoadjuvant treatment protocols. This review aims to elucidate the role of radiotherapy based on the current evidence and to assess ongoing and future trials that may address existing knowledge gaps. It will also underscore the challenges in making definitive recommendations about radiotherapy, particularly as technologies and treatment modalities continue to advance. |
| format | Article |
| id | doaj-art-e3b3b2790a754f089b54cae790eec8a4 |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-e3b3b2790a754f089b54cae790eec8a42025-08-20T03:51:29ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.16139541613954Preoperative radiotherapy in patients with locally advanced esophageal squamous cell carcinoma: a narrative reviewYan Lin0Shou-Feng Wang1Huan-Wei Liang2Yang Liu3Wei Huang4Xin-Bin Pan5Department of Gastroenterology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, ChinaDepartment of Thoracic Surgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, ChinaDepartment of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, ChinaDepartment of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, ChinaDepartment of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, ChinaDepartment of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, ChinaNeoadjuvant treatments play a crucial role in improving survival rates for patients with locally advanced resectable esophageal cancer. The CROSS and NEOCRTEC5010 trials have shown that neoadjuvant concurrent chemoradiotherapy significantly enhances survival compared to surgery alone. In contrast, the NeoRes and CMISG1701 trials indicate that while neoadjuvant chemoradiotherapy yields a higher histological complete response rate, it does not confer survival benefits over neoadjuvant chemotherapy. The recent JCOG1109 trial has demonstrated that neoadjuvant triplet chemotherapy offers a statistically significant overall survival advantage compared to doublet chemotherapy. However, combining doublet chemotherapy with radiotherapy did not show notable survival improvement compared to doublet chemotherapy alone. Additionally, neoadjuvant immunotherapy in conjunction with chemotherapy has shown a greater histological complete response rate compared to neoadjuvant chemotherapy, with comparable rates to neoadjuvant chemoradiotherapy. These findings have sparked debate regarding the necessity of radiotherapy in neoadjuvant treatment protocols. This review aims to elucidate the role of radiotherapy based on the current evidence and to assess ongoing and future trials that may address existing knowledge gaps. It will also underscore the challenges in making definitive recommendations about radiotherapy, particularly as technologies and treatment modalities continue to advance.https://www.frontiersin.org/articles/10.3389/fonc.2025.1613954/fullesophageal cancersurgeryradiotherapychemotherapyimmunotherapy |
| spellingShingle | Yan Lin Shou-Feng Wang Huan-Wei Liang Yang Liu Wei Huang Xin-Bin Pan Preoperative radiotherapy in patients with locally advanced esophageal squamous cell carcinoma: a narrative review Frontiers in Oncology esophageal cancer surgery radiotherapy chemotherapy immunotherapy |
| title | Preoperative radiotherapy in patients with locally advanced esophageal squamous cell carcinoma: a narrative review |
| title_full | Preoperative radiotherapy in patients with locally advanced esophageal squamous cell carcinoma: a narrative review |
| title_fullStr | Preoperative radiotherapy in patients with locally advanced esophageal squamous cell carcinoma: a narrative review |
| title_full_unstemmed | Preoperative radiotherapy in patients with locally advanced esophageal squamous cell carcinoma: a narrative review |
| title_short | Preoperative radiotherapy in patients with locally advanced esophageal squamous cell carcinoma: a narrative review |
| title_sort | preoperative radiotherapy in patients with locally advanced esophageal squamous cell carcinoma a narrative review |
| topic | esophageal cancer surgery radiotherapy chemotherapy immunotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1613954/full |
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