Efficacy and Survival Analysis of Apatinib Combined with Capecitabine Chemotherapy for Second-line Treatment of Advanced Esophageal Cancer

This study explore the efficacy, toxic and side effects and survival impact of apatinib combined with capecitabine chemotherapy for the second-line treatment of advanced esophageal cancer. The clinical data of 76 patients with advanced esophageal cancer treated from January 2015 to April 2020 have been retrospectively analyzed. They are divided into experimental and control groups according to different treatment methods. The experimental group (n=29) underwent oral apatinib targeted therapy (250 mg/once/d) combined with oral capecitabine chemotherapy (1000 mg/m² according to the body surface area on D1-14). Maintenance therapy with apatinib has been conducted after 4-6 cycles. The control group (n=47) received the second-line chemotherapy. After more than 2 cycles of chemotherapy, complete response is achieved in 0 cases, partial response in 19 cases, stable disease in 6 cases, and progressive disease in 3 cases. Overall response rate (ORR) is found to be 67.86% and the disease control rate is 89.28%. The median progression-free survival (mPFS) and the median overall survival (mOS) are 6.7 months and 8.9 months, respectively. Karnofsky Performance Status score of 2 points, liver metastasis, elevation of tumor marker squamous cell carcinoma and unsatisfactory efficacy are independent prognostic factors. In control group, ORR was 34.04%, and mPFS and mOS are 3.9 months and 7.4 months, respectively. No severe drug-related toxic and side effects have been observed, except for 1 patient who voluntarily discontinued treatment due to grade III hypertension. Apatinib combined with capecitabine chemotherapy shows good overall efficacy with satisfactory safety and tolerance for the second-line treatment of advanced esophageal cancer.