For patients with distal esophageal adenocarcinoma who are not surgical candidates, how do you decide between the preferred chemotherapy regimens when given as definitive chemo-radiation?

My regimen of choice has fluctuated over the years. At MSKCC, our institutional standard was previously cisplatin/irinotecan (Ilson, Cancer 2012). This was abandoned after the results of the CROSS study were presented in 2010, establishing a global benchmark for tolerability and a highly respectable...

There are no randomized data to guide this decision. Multiple retrospective studies indicate that carboplatin/paclitaxel is similar in efficacy to cisplatin/5-FU with less toxicity. Consequently, I favor weekly carboplatin/paclitaxel for neoadjuvant and definitive chemoradiation. As @Dr. First Last ...