Early Palliative Care in Metastatic Esophageal Squamous Carcinoma (ESCC) and Gastric Cancer

Inclusion Criteria: * Having signed informed consent * Age ≥18 years old * Histologically confirmed esophageal squamous carcinoma and gastric adenocarcinoma, metastatic disease. * Measurable disease according to the RECIST criteria(diameter of the lesion should be more than 10mm by spiral CT or MRI, more than 20mm by common CT, the date of image should be less than 15 days before enrollment) * Karnofsky performance status ≥80 * Life expectancy of ≥ 3 month * WBC \> 3,000/mm3, absolute neutrophil count ≥1500/mm3, platelet \> 100,000/mm3, Hb \> 9g/dl(within 14 days before enrollment),ALT and AST \< 2.5 times ULN (≤5 times ULN in patients with liver metastases),Bilirubin level \< 1.0 times ULN,Serum AKP \< 2.5 times ULN,Serum creatinine \< 1.5 times ULN * No sever complication, such as active gastrointestinal bleeding, perforation, jaundice, obstruction, non-cancerous fever \> 38℃； * Normal ECG and heart function * Fertile patients must use effective contraception * Good compliance Exclusion Criteria: * Previous treatment of palliative chemotherapy * Only with Brain or bone metastasis * No measurable lesions, eg. pleural fluid and ascites * Suffer from severe heart disease or disease with other important organs * Chronic diarrhea or renal dysfunction * Pregnancy or lactation period * Other previous malignancy within 5 year, except non-melanoma skin cancer Chronic diarrhea * Mentally abnormal or disable cognition,including CNS metastasis