Brief Article
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World J Gastroenterol. Dec 28, 2013; 19(48): 9447-9452
Published online Dec 28, 2013. doi: 10.3748/wjg.v19.i48.9447
Nedaplatin concurrent with three-dimensional conformal radiotherapy for treatment of locally advanced esophageal carcinoma
Ze-Tian Shen, Xin-Hu Wu, Bing Li, Jun-Shu Shen, Zhen Wang, Jing Li, Xi-Xu Zhu
Ze-Tian Shen, Xin-Hu Wu, Bing Li, Jun-Shu Shen, Zhen Wang, Jing Li, Xi-Xu Zhu, Department of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
Author contributions: Shen ZT and Wu XH as co-first authors contributed equally to this study; Zhu XX designed the study and provided financial support for this work; Li B and Shen JS were responsible for the physical planning; Shen ZT, Wu XH, Wang Z and Li J were responsible for clinical observation, follow-up and data analysis; Shen ZT and Wu XH wrote the manuscript; all authors have approved the final article.
Correspondence to: Xi-Xu Zhu, MD, Department of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province, China. simon_doctor@163.com
Telephone: +86-25-80860079 Fax: +86-25-80860078
Received: October 13, 2013
Revised: November 20, 2013
Accepted: December 5, 2013
Published online: December 28, 2013
Processing time: 92 Days and 22.9 Hours
Abstract

AIM: To evaluate the efficacy and toxicity of nedaplatin (NDP) concurrent with radiotherapy in the treatment of locally advanced esophageal carcinoma.

METHODS: Sixty-eight patients with locally advanced esophageal carcinoma were randomized into either a NDP group (n = 34) or a cisplatin (DDP) group (n = 34). The NDP group received NDP 80-100 mg/m2iv on day 1 + leucovorin (CF) 100 mg/m2iv on days 1-5 + 5-fluorouracil (5-FU) 500 mg/m2iv on days 1-5. The DDP group received DDP 30 mg/m2iv on days 1-3 + CF 100 mg/m2 on days 1-5 + 5-FU 500 mg/m2iv on days 1-5. The treatment was repeated every 4 wk in both groups. Concurrent radiotherapy [60-66 Gy/(30-33 f)/(6-7 wk)] was given during chemotherapy.

RESULTS: There was no significant difference in the short-term response rate between the NDP group and DDP group (90.9% vs 81.3%, P = 0.528). Although the 1- and 2-year survival rates were higher in the NDP group than in the DDP group (75.8% vs 68.8%, 57.6% vs 50.0%), the difference in the overall survival rate was not statistically significant between the two groups (P = 0.540). The incidences of nausea, vomiting and nephrotoxicity were significantly lower in the NDP group than in the DDP group (17.6% vs 50.0%, P = 0.031; 11.8% vs 47.1%, P = 0.016; 8.8% vs 38.2%, P = 0.039). There was no significant difference in the incidence of myelosuppression, radiation-induced esophagitis or radiation-induced pneumonia between the two groups.

CONCLUSION: NDP-based concurrent chemoradiotherapy is effective and well-tolerated in patients with locally advanced esophageal carcinoma. NDP-based regimen has comparable efficacy to DDP-based regimen but is associated with lower incidences of gastrointestinal and renal toxicity.

Keywords: Esophageal carcinoma; Chemoradiotherapy; Nedaplatin; Cisplatin

Core tip: This paper describes patients with locally advanced esophageal carcinoma who underwent nedaplatin (NDP) concurrent with radiotherapy. The survival and local control as well as the side effects during follow-up were analyzed by comparing with cisplatin (DDP). We found that NDP-based concurrent chemoradiotherapy is effective and well-tolerated. Compared with DDP, NDP-based concurrent chemoradiotherapy exhibits favorable efficacy with lower toxicity.