Clinical Progress in Platinum-based Chemotherapy for Esophageal Cancer / 中国肿瘤临床

ABSTRACT

The esophagus carcinoma is one of the most common cancers in China. The therapy modes for esopha-gus carcinoma include surgery, radiotherapy and chemotherapy. Platinum-based combined chemotherapy has always been used in the treatment for esophagus carcinoma. In this article, we reviewed the application of platinum-based chemo-therapy in esophageal cancer in recent years. The efficacy of cisplatin in treating esophageal cancer has been proved. Cis-platin is used in neoadjuvant chemotherapy, adjuvant chemotherapy, concurrent chemo-radiotherapy and salvage chemo-therapy for esophageal cancer. Combined chemotherapy with 5-fluorouracil (5-FU) and cisplatin is regarded as the stan-dard regimen for esophageal cancer in concurrent chemoradiotherapy and salvage chemotherapy. Compared with cisplat-in, carboplatin causes lower rate of nephrotoxicity, reactions in the digestive tract and ototoxicity. But carboplatin does not have better effect. Patients with esopohageal adenocarcinoma show good clinical response to oxaliplatin and relatively sat-isfactory median survival. The rate of nephrotoxicity and reactions of digestive tract caused by cisplatin is lower. Oxaliplatin can lead to serious neurotoxicity. The therapeutic efficacy of nedaplatin is as good as that of cisplatin. Nedaplatin is used in concurrent chemoradiotherapy and salvage chemotherapy for esophageal squamous cell carcinoma. Compared with cispla-tin, nedaplatin can result in myelosuppression. Further research is warranted to explore whether nedaplatin can take place of cisplatin as the standard regimen. Lobaplatin combined with 5-fluorouracil (5-Fu) and leucovorin (CF) is effective and well tolerated for advanced esophagus carcinoma. The major toxicities noted are reversible bone marrow suppression and gastrointestinal tract reaction.