Neoadjuvant radio-chemo-immunotherapy impact on postoperative patient-reported outcomes in oesophageal cancer

OBJECTIVES Clinical trials have shown promising clinical and safety outcomes of neoadjuvant chemoradiotherapy combined with immunotherapy (nICRT) in patients with resectable oesophageal cancer. However, knowledge of the impact of nICRT on symptomatic improvement and quality of life (QOL) remains scarce. Therefore, this study compared postoperative patient-reported outcomes (PROs) in patients with oesophageal cancer receiving nICRT and those receiving neoadjuvant chemoradiotherapy alone (nCRT). METHODS Among 92 patients, 25 were selected from each group after propensity score matching. Repeated-measures analysis of variance (RM-ANOVA) was used to assess differences in QOL, symptoms, anxiety, and depression using the M.D. Anderson Symptom Inventory (MDASI), Quality of Life Questionnaire Core 30 (QLQ-C30), and Hospital Anxiety and Depression Scale (HADS). RESULTS After matching, no significant differences were observed in overall health status or functional scores (P > 0.05). However, the nICRT group reported better nausea, vomiting, and pain scores (P < 0.05). Over time, both groups showed significant improvements in overall health (F = 5.222, P < 0.01) and functional subscale scores (physical, role, emotional, and cognitive; all P < 0.001). The nICRT group demonstrated significantly better pain, fatigue, nausea, and vomiting scores (P < 0.05). Anxiety and depression improved significantly in both groups (P < 0.001), with greater anxiety reduction in the nICRT group (P < 0.05). CONCLUSIONS The nICRT group exhibited better QOL, fewer adverse symptoms, and lower anxiety and depression levels postoperatively, suggesting that nICRT may enhance recovery.