Apatinib as First -Line Treatment for Advanced Esophagus Cancer

Inclusion Criteria:

* 1\. Age: 18 to 75 years old, men and women;
* 2\. Patients diagnosed with esophageal squamous cell carcinoma by histopathology and immunohistochemistry;
* 3\. ECOG performance status: 0-2;
* 4\. Life expectancy ≥ 12 weeks;
* 5\. Clinical stage IIIb-IV; metastatic patients who have not initially received chemotherapy or patients who have local recurrence after surgery or radiochemotherapy (no local treatment indication) ;
* 6\. Function of the major organs is normal, criteria referred are as follow:

  1. blood routine examination: HB ≥ 90g/L (no blood transfusion within 14 days); ANC ≥ 1.5 × 109/L; PLT ≥ 80 × 109/L;
  2. biochemical examination: ALB ≥ 29 g / L (AlB did not lose within 14 days); ALT and AST \<5 ULN; TBIL ≤ 1.5 ULN;
  3. plasma examination Cr ≤ 1.5 ULN;
* 7\. Subjects voluntarily participated in the study, signed informed consent, have good compliance and cooperate with follow-up;
* 8\. Patients that the investigator believes can benefit.

Exclusion Criteria:

* 1\. Those who have had other malignant tumors in the past or at the same time;
* 2\. Pregnant or lactating women;
* 3\. Patients with high blood pressure and can't get a good control after antihypertensive drug therapy (systolic blood pressure\>150mmHg, diastolic blood pressure\>100mmHg); patients with grade Ⅱ or more myocardial ischemia or myocardial infarction, poorly controlled arrhythmia (including QTC interval≥450ms) and Ⅲ\~Ⅳ grade cardiac insufficiency according to NYHA; cardiac color Doppler ultrasonography: LVEF \<50%;
* 4\. Unable to swallow, chronic diarrhea, and intestinal obstruction, which significantly affects drug taking and absorption;
* 5\. Have a clear risk of gastrointestinal bleeding concerns (such as local active ulcer lesions, fecal occult blood + or more), a history of gastrointestinal bleeding within 6 months;
* 6.With coagulation abnormalities (PT\>16 s, APTT\>43 s, TT\>21 s, Fbg \<2 g/L), hemorrhagic tendency or receiving thrombolysis or anticoagulant therapy;
* 7\. Have a mental illness, or history of abuse of psychotropic substances;
* 8\. With anastomotic recurrence and tracheal fistula;
* 9\. Patients who participated in other drug clinical trials within 4 weeks;
* 10\. Patients who have concomitant diseases that are seriously compromise the patient's safety or affect the patient to complete the study according to the researcher's judgment;
* 11\. Researchers believe that it is not suitable for inclusion.