Optimizing Neoadjuvant Treatment Regimens for Locally Advanced Esophageal Squamous Cell Carcinoma

Inclusion criteria

• male or female
• Age ≥ 18 years old
• Pathological confirmation of esophageal squamous cell carcinoma
• Endoscopic ultrasound, enhanced CT scan of the neck, chest, and abdomen, and esophageal magnetic resonance imaging evaluate as T3 or resectable T4 PET/CT、 Cervical, thoracic, and abdominal enhanced CT evaluation of N0 or N+
• No clear distant metastasis (M0) and only cervical or supraclavicular lymph node metastasis (M1a)
• Tumor longitudinal diameter ≤ 10cm
• The tumor did not involve the dentate line
• ECOG score 0 or 1
• No hematological diseases, no liver or kidney dysfunction
• Absolute neutrophil count ≥ 1.5 × 109/L
• Platelets ≥ 100 × 109/L
• Hemoglobin ≥ 11g/L
• ALT ≤ 2 times the upper limit of normal value
• TBil ≤ 1.5 times the upper limit of normal value
• Creatinine clearance rate (Cockroft) ≥ 50ml/min
• Obtain informed consent

Exclusion criteria

• T staging evaluation is T1/T2
• PET/CT and other evaluations show distant metastasis (M1)
• Planned pregnancy or patients during pregnancy or lactation
• History of previous chemotherapy, radiation therapy, or immunotherapy
• Previous severe coronary heart disease and heart failure (NYHA grade III/IV)
• Previous pulmonary interstitial fibrosis or severe pulmonary dysfunction that cannot tolerate surgery
• Previous autoimmune disease requiring systemic treatment within 2 years
• Previous immunodeficiency diseases or the need for systemic steroid replacement therapy
• Previous motor or sensory neurotoxic diseases
• Previous mental illness
• Potential diseases that may affect patients' ability to receive planned treatment, such as drug allergies
• Acute infectious diseases requiring systemic treatment
• Previous HIV, HBV, or HCV infections
• Previously received stem cell or solid organ transplantation