We retrospectively evaluated the efficacy of combined chemotherapy with nedaplatin, adriamycin, and 5-FU (NAF), as well as clinical factors affecting its effect in patients with advanced esophageal cancer. A total of 104 patients with advanced esophageal cancer received 2 courses of NAF-chemotherapy between February 2003 and March 2010. The response rate according to the RECIST criteria was 38. 5%, and the response of the primary lesion was 51. 9%, according to the endoscopic evaluation of chemotherapy by the Japanese Esophageal Society. On multivariate analysis, factors such as nutritional status, CRP levels before treatment and adverse effects during chemotherapy did not significantly affect the efficacy of the NAF regimen. NAF-chemotherapy for advanced esophageal cancer was very effective even when patients had malnutrition or high CRP levels.