How would you treat a patient with pT1b/T2 adenocarcinoma of mid esophagus with residual cancer after endoscopic resection and who is a poor surgical candidate?

I agree completely with @Dr. First Last.

Here’s a multi-institutional series suggesting 3-year OS and PFS of 80% and 60% amongst a predominately elderly, high comorbidity, T1bN0 distal esophagus/GEJ adenocarcinoma cohort who received definitive chemoradiation (Deng et al., PMID 33083658).

If the patie...

Assuming the patient can tolerate an RT/chemo regimen, I would treat to a dose of 50-54 Gy with concurrent chemotherapy, such as the CROSS regimen. We know that local control can be obtained with RT/chemo alone and with known residual this would be a reasonable approach. I would use margins similar ...