Changes in Local Tumor Immune Microenvironment With Neoadjuvant Cryotherapy and Chemoradiation for Locally Advanced Esophageal Cancer

Introduction: We aimed to assess the effect of spray cryotherapy (LNSC) on immune-microenvironment of esophageal cancer (EC). Methods: Matched retrospective case-control study of locally advanced EC patients who underwent LNSC plus chemoradiation (CRYOCHEMOXRT) versus chemoradiation alone (CHEMOXRT). A microarray was generated from pre- and post-treatment tissue blocks and subjected to multiplex immunofluorescence. Results: Intra-tumor T lymphocytes (IT-TILs) and cytotoxic T-cells increased more frequently with CRYOCHEMOXRT versus CHEMOXRT. Mean survival was 1402 versus 686 days with and without 5× increase in IT-TILs. Discussion: LNSC may stimulate an anti-tumor immune response that enhances effectiveness of neoadjuvant CRT in locally advanced EC.