SYSTEMATIC REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
This article is part of the Research TopicThe Role of Immunotherapy in Cancer Therapy and Its ChallengesView all 8 articles
Research trends in neoadjuvant therapy for esophageal cancer: a bibliometric and meta-analysis
Provisionally accepted
- Department of Thoracic Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
BACKGROUND: Neoadjuvant treatment followed by radical surgery has become the standard treatment approach for locally advanced esophageal cancer. We aimed to explore the development trends, research hotspots, and differences among treatment regimens in this field using bibliometric analysis and meta-analysis. METHODS: Literature on neoadjuvant therapy for esophageal cancer was retrieved from PubMed, Embase, Cochrane Library, and Web of Science. Bibliometric analysis and visualization were conducted on publications since 2000 from Web of Science Core Collection (WoSCC) using CiteSpace, VOSviewer, and the bibliometrix package in RStudio. A meta-analysis of phase III randomized controlled trials (RCTs) involving different treatment regimens was performed using Stata/MP, based on studies screened from all four databases. RESULTS: A total of 1,324 and 27 studies were included in the bibliometric analysis and meta-analysis, respectively. Overall, there was an increasing trend in the volume of publications in this field. The United States and the Karolinska Institute emerged as the leading country and institution in terms of publication volume. The most frequently cited journals and authors were Annals of Surgery and van Hagen P, respectively. Research hotspots have primarily focused on neoadjuvant chemotherapy (NCT) and chemoradiotherapy (NCRT), with a recent shift toward neoadjuvant immunotherapy (NIT). The pooled complete pathological response (pCR) rates were 0.08 for NCT, 0.29 for NCRT, 0.22 for neoadjuvant chemoimmunotherapy (NCIT), and 0.27 for NCRT combined with targeted therapy (NCRT+NTT). The pooled rates of tumor regression grade 1 (TRG1) were 0.09, 0.25, 0.30, and 0.37, respectively. The R0 resection rates were 0.87, 0.96, 0.99, and 0.96, while the incidence of grade ≥3 treatment-related adverse events (TRAEs) was 0.37, 0.66, 0.25, and 0.69, respectively. CONCLUSIONS: Neoadjuvant therapy for esophageal cancer has evolved significantly over the past decades. Recently, NIT has emerged as a key area of research interest. However, its clinical efficacy and safety require validation through long-term follow-up data from future phase III RCTs.
Keywords: esophageal cancer, Neoadjuvant Therapy, Treatment regimens, Immunotherapy, bibliometric analysis, Meta-analysis
Received: 13 Jun 2025; Accepted: 03 Nov 2025.
Copyright: © 2025 Wang, Zhang, Yang and Chang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hao Chang, doctorhaochang@sohu.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.