Apatinib Combined With Chemotherapy for Esophageal Squamous Cell Cancer After the Failure of Standard Treatment

• 1.Male or female patients, age:≥18 years old.
• 2.Confirmed by histology of recurrent or metastatic esophageal squamous cell carcinoma.
• 3.Patients who undergo local or recurrent metastases after surgery and / or radiotherapy and chemotherapy,at least one measurable lesion(tumor lesions CT scan length ≥ 10 mm,lymph node lesions CT scan short diameter ≥ 15 mm,scan layer thickness is not greater than 6 mm).
• 4.The ECOG physical status score: 0 to 2.
• 5.Expected survival ≥ 3 months.
• 6.Subjects received other treatment damage have been restored, which received nitroso or mitomycin interval ≥ 6 weeks; to accept other cytotoxic drugs, radiotherapy or surgery ≥ 4 weeks, and the wound has been completely healed;

• 7.The main organs function properly:

  1. blood routine examination standards to be met (14 days without blood transfusion and blood products):

     1. HB≥90g/L;
     2. ANC≥1.5×109/L;
     3. PLT≥80×109/L;

  2. biochemical tests to meet the following criteria:

     1. TBIL\<1.5×ULN;
     2. ALT and AST\<2.5×ULN, and \<5×ULN for patients with liver metastases
     3. Serum Cr≤1.5×ULN or endogenous creatinine clearance> 45ml/min (Cockcroft-Gault formula);
• 8.The women of childbearing age must have taken reliable contraceptive measures or have a pregnancy test (serum or urine) within 7 days prior to enrollment and have a negative result and are willing to use the appropriate method at 8 weeks after the trial and the last given test contraception.For the man, consent should be given to appropriate contraception or surgical sterilization 8 weeks after the trial and at the last time the test drug was given;
• 9.Patients should be voluntary to the trial and provide with signed informed consent

Exclusion Criteria:

• 1.Pregnant or lactating women;
• 2.Patients with high blood pressure and who can not be reduced to normal range by antihypertensive therapy (systolic blood pressure> 140 mmHg, diastolic blood pressure> 90 mmHg) with myocardial infarction or myocardial infarction, arrhythmia and grade II heart Incomplete function;
• 3.Have a significant impact on oral drug absorption factors, such as unable to swallow, chronic diarrhea and intestinal obstruction;
• 4.Coagulation dysfunction(INR>1.5 or prothrombin time (PT)>ULN + 4 seconds or APTT>1.5×ULN),with bleeding tendency or are receiving thrombolytic or anticoagulant therapy;
• 5.with a clear gastrointestinal bleeding concerns (such as local active ulcer lesions, fecal occult blood + + above), 6 months of history of gastrointestinal bleeding;
• 6.Central nervous system metastasis with symptoms;
• 7.The investigator judged other circumstances that will affect the conduct of the study and the outcome of the study