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Gastrointestinal Cancers • Medical Oncology
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?
Answer from: Radiation Oncologist at Community Practice
I agree completely with @Joel E. Tepper.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...
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Answer from: Radiation Oncologist at Academic Institution
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 ...