To evaluate the efficacy and safety of apatinib combined with S-1 in the treatment of advanced esophageal cancer and its influencing factors.

From March 2020 to March 2023, 91 patients with advanced esophageal cancer in Dangtu County People's Hospital were treated with apatinib combined with S-1. The objective remission rate and the incidence of adverse drug reactions in the two groups were evaluated with the objective remission after 4 cycles of treatment as the efficacy evaluation standard and the occurrence of adverse drug reactions during treatment as the safety evaluation standard. The clinical data of patients with objective remission, non-objective remission, occurrence and absence of adverse drug reactions were compared, and Logistic multivariate regression model was used to summarize the related factors affecting the efficacy and safety of apatinib combined with S-1 in the treatment of advanced esophageal cancer.

All 91 patients completed 4 cycles of treatment. After 4 cycles of treatment, no patients achieved complete remission, 30 patients were partial remission, 42 patients were stable disease and 19 patients were progressive disease. The objective remission rate of patients was 32.97%. During the treatment, the main adverse drug reactions were hand-foot syndrome, nausea, secondary hypertension, leukopenia and vomiting, and grade 3-4 adverse reactions were rare. Among 91 patients, 65 (71.43%) had one or more adverse reactions. Logistic multivariate regression analysis showed that recurrence and metastasis sites ≥2 were independent influencing factors of non-objective remission, and local metastasis was the protective factor; The first-line chemotherapy regimen of paclitaxel+cisplatin was an independent influencing factor of adverse reactions, and the body surface area of 1.25-<1.5 m² was a protective factor.

The efficacy and safety of apatinib combined with S-1 in the treatment of advanced esophageal cancer are worthy of recognition. The main factors affecting the efficacy and safety are the location of recurrence and metastasis, the distance of metastasis, the body surface area and the first-line chemotherapy regimen.