This retrospective study compared the efficacy and safety of
nedaplatin-based
chemoradiotherapy and
cisplatin-based
chemoradiotherapy in stage II-IVa
nasopharyngeal carcinoma (NPC) patients. Patients treated with
cisplatin-based or
nedaplatin-based
chemoradiotherapy between January 2012 and December 2015 were evaluated. Survival was estimated by the Kaplan‒Meier method and compared by the log-rank test. Multivariate analysis was performed using the Cox proportional hazards model. A cohort of 538 NPC patients was enrolled. There were no significant differences in the 5-year overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRRFS), or distant
metastasis-free survival (DMFS) between the
cisplatin and
nedaplatin groups. During the whole treatment course, patients in the
cisplatin group had higher incidences of grade 3‒4
vomiting and
anorexia, while patients in the
nedaplatin group had higher incidences of grade 3‒4 leucopenia and
mucositis. In terms of late toxicities, patients in the
cisplatin group had a higher incidence of
xerostomia. In multivariate analysis, T stage, N stage, and clinical stage were prognostic factors for OS, PFS, and DMFS. In subgroup analyses,
nedaplatin-based
chemotherapy achieved comparable treatment outcomes in specific populations stratified by age, sex, ECOG PS score and clinical stage.
Cisplatin and
nedaplatin are effective choices for stage II-IVa NPC patients, with a different spectrum of side effects.