Short-Term Efficacy And Safety Of Neoadjuvant Sindilimab Combined With Chemotherapy For Locally Advanced Resectable Esophageal Squamous Cell Carcinoma

Objective: To observe the short-term efficacy and safety of neoadjuvant sintilimab combined with albumin paclitaxel and cisplatin in the treatment of locally advanced resectable thoracic esophageal squamous cell carcinoma.Methods: From January 2020 to December 2022,patients with locally advanced resectable thoracic esophageal squamous cell carcinoma who were treated in the second ward of thoracic surgery and its cooperative units of Jining First People’s Hospital were retrospectively analyzed.The patients were divided into simple surgery group(group S)and neoadjuvant immunotherapy combined with chemotherapy plus operation group(group n ICS).Group S was directly treated with surgery.Group n ICS received albumin paclitaxel injection(200mg/ ㎡)and cisplatin(80mg/ ㎡),and the next day was injected with sintilimab injection(200mg),21 days was a cycle.Preoperative neoadjuvant therapy was 2-4 cycles,and then surgical treatment was performed.The pathological complete remission rate(p CR),main pathological remission rate(MPR)and safety of perioperative treatment in group n ICS were observed.The R0 resection rate,postoperative complications,disease-free survival(DFS)and overall survival(OS)were compared between the two groups.Results: The patients in the group n ICS were treated with neoadjuvant sintilimab combined with albumin paclitaxel and cisplatin.All patients successfully completed the operation without delay.The p CR was(8/47,17.0%),MPR(29/47,61.7%),R0 resection rate(46/47,97.9%)in the n ICS group.The common immune and chemotherapy-related adverse reactions were mostly mild grade 1-2 adverse events,and the incidence of grade 3-4 adverse reactions was low.Most of the surgical complications were grade 1-2,and no perioperative death occurred.Compared with group S,there was no increase in the difficulty of surgery and postoperative complications(P>0.05),and it could reduce the probability of recurrence and metastasis and increase the survival time of patients(P<0.05).Conclusion: Neoadjuvant sintilimab combined with chemotherapy has satisfactory efficacy and high safety as a treatment for locally advanced resectable thoracic esophageal squamous cell carcinoma.It is expected to become a new treatment for locally advanced resectable esophageal squamous cell carcinoma and bring hope to patients.