How do you follow up a patient with esophageal adenocarcinoma who is not a surgical candidate after finishing chemoradiation?

2 Answers

Mednet MemberInvited Expert

Medical Oncology · University of Wisconsin

Answered on

I am assuming that this patient has adenocarcinoma and also had definitive dosing radiation (50.4 Gy +) and not neoadjuvant dosing as was used in the CROSS trial (41.4 Gy). If that is the case, you would use the same surveillance as you would after surgery which is H&P every 3-6 mo with labs and scans and endoscopy as clinically indicated. I like to do scans twice a year and an endoscopy at one year or sooner if dysphasia occurs. These guidelines are well laid out in the NCCN guidelines for esophageal cancer and allow for personalization based on the patient’s status and goals.

NCCN guidelines Ajani et al., PMID 31319389

CROSS trial van Hagen et al., PMID 22646630

Mednet Member

Radiation Oncology · Stroger Hospital

Answered on

Follow up at 3-6 months.

Lab feats with 3 months.

Endoscopy when indicated by symptoms.