Clinical study of nedaplatin combined with three dimensional conformal radiotherapy in the treatment of local advanced esophageal carcinoma

Objective:To study the efficacy and toxicity of neoadjuavant chemotherapy for combined radiotherapy with nedaplatin and cisplatin in the treatment of local advanced esophageal carcinoma.Methods:A total of 68 patients with local advanced esophageal carcinoma were randomized into the NDP group(n=34) and the DDP group(n=34).Chemo-regime:nedaplatin(80-100)mg/m2 d1,CF 100mg/m2d1-5,5-FU 500 mg/m2 d1-5;cisplatin 30 mg/m2 d1-3,CF 100mg/m2d1-5,5-FU 500 mg/m2 d1-5.Radiotherapy:NDP and DDP groups were(60-66)Gy/[(30-33f)·(6-7weeks)].Results:The efficacy of NDP group was 90.9% and DDP group was 81.3%.There was no significant difference between the two groups in curative effect(P=0.528).The 1-year and 2-year local control rate were 75.8% and 57.6% in NDP group,68.8% and 50.0% in DDP group.Compared with DDP group,NDP group obtained higher local control rate and survival rate,but the difference was not significant(P=0.540).NDP group had lower reaction rate,nausea(17.6%) and vomiting(11.8%) occurred in NDP group,compared to that which occurred in DDP group(50.0%,47.1%),with a significant difference between the two groups(P=0.031,0.016).There was lower nephrotoxicity in NDP group(8.8%) than in DDP group(38.2%),with a significant difference between the two groups(P=0.039).There was no significant difference between the two groups in the incidence of myelosuppression,radiation-induced esophagitis and radiation-induced pneumonia(P0.05).Conclusion:DNP regimen is effective and well-tolerated in patients with advanced esophageal carcinoma.There is no significant difference between nedaplatin and cisplatin regimens in the efficiency and there is a lower digestive reaction and nephrotoxicity than in cisplatin group.