For a patient with metastatic, poorly differentiated esophageal adenocarcinoma with an excellent systemic response to chemotherapy for 1 year, who now presents with isolated local progression and no new distant disease, would you consider treating the primary site with a higher palliative RT dose for more durable control?

For genuine oligoprogression limited to the primary tumor, in a patient who is otherwise fit and responding to systemic therapy at distant sites for ≥1 year, I would definitely consider a higher RT dose aimed at durable local control, not just short-term symptom relief. The exact regimen would obvio...

This is an increasingly common scenario as systemic therapy improves. In the absence of data, many approaches are acceptable. Reasoning from first principles, the patient described in this scenario is very different from a patient with widely metastatic disease who has progressed through multiple li...

Escalating to a definitive-level dose (rather than a conventional low palliative dose) is a reasonable, evidence-supported strategy in this favorable oligoprogressive scenario, with the most supporting data being largely retrospective and concentrated in squamous histology, and dose escalation beyon...