Abstract: Objective To investigate the efficacy of programmed cell death protein 1(PD-1)inhibitor combined with paclitaxel and nedaplatin in the first line therapy for advanced esophageal squamous cell carcinoma(ESCC)in the elderly. Methods A total of 60 elderly patients with ESCC admitted to our hospital from January 2020 to January 2021 were enrolled and divided into the chemotherapy group(paclitaxel and nedaplatin) and the immunotherapy group(camrelizumab combined with paclitaxel and nedaplatin), with 30 cases in each group. The efficacy, T-lymphocyte subsets, and adverse reactions of the two groups were observed and compared. Results The disease control rate in the immunotherapy group was significantly higher than that in the chemotherapy group (83.3% vs 60.0%,P＜0.05). There were no statistically significant differences in the levels of T-lymphocyte subsets between the two groups. The most common adverse reactions in immunotherapy group were anemia, reactive capillary hyperplasia and leukopenia, compared with anemia, leukopenia and vomit in chemotherapy group. Conclusions The combination of camrelizumab monotherapy with chemotherapy can improve the disease control rate with good safety in the elderly patients with advanced ESCC, which can be promoted in clinical practice.

Key words: advanced esophageal squamous cell carcinoma, efficacy, safety, camrelizumab, paclitaxel, nedaplatin, T-lymphocyte subsets