Neoadjuvant Therapy in Multimodal Surgical Treatment for Squamous Cell Carcinoma of the Esophagus

Postoperative chemotherapy was initially conducted with surgical treatment as part of a multimodal treatment strategy for esophageal squamous cell carcinoma. Subsequently, a randomized trial comparing post- versus pre-operative chemotherapy with cisplatin and 5-fluorouracil demonstrated the superior efficacy of neoadjuvant treatment with FP(CF). However, the results of subgroup analysis based on T factor revealed no efficacy for cT3 tumors. To improve the survival rate in patients with cT3 tumors, treatments with neoadjuvant chemotherapy using FP(CF)plus docetaxel and concurrent FP(CF)plus radiation were conducted to assess the feasibility of preoperative adjuvant treatment and surgery after neoadjuvant treatment. These neoadjuvant regimens are expected to improve outcomes following surgical treatment. A randomized controlled phase III trial comparing FP(CF)versus DCF versus FP(CF)-RT as neoadjuvant treatments for locally advanced esophageal cancer is currently under investigation.