Abstract
The rates of survival are low in patients with refractory advanced esophageal cancer in whom chemotherapy, radiotherapy and immunotherapy have failed. In the present report, the case of a 59-year-old male with dysphagia and paraneoplastic leukemoid reaction who was diagnosed with esophageal squamous cell cancer with multiple bone and left adrenal gland metastases, is described. Tumor progression continued after multiline chemotherapy with paclitaxel, platinum and irinotecan; immunotherapy with camrelizumab; and radiotherapy. Furthermore, the patient experienced grade 3 hematologic toxicities and immune-induced myocarditis. As fourth-line therapy, anlotinib was administered in combination with S-1. Thereafter, the patient's progression-free survival was 16.7 months, indicating that anlotinib combined with S-1 may be effective in refractory advanced esophageal cancer.