In a patient with gastroesophageal adenocarcinoma treated with neoadjuvant chemoimmunotherapy who had a good response but is unable to undergo surgery, how would you approach radiation therapy?

As the ARTDECO study did not show a difference in local control between 50.4 Gy and 61.6 Gy (given with carbo/taxol, but FOLFOX is also an option per PRODIGE5, depending on chemotherapy used as part of the initial chemo-IO), I would suggest 50.4 Gy.

I would treat with definitive chemoradiation with 50.4 Gy. There are data to support induction chemotherapy followed by PET-adapted chemoradiation and then surgery, and have shown excellent pCR rates, particularly for patients who are PET responders. In the CALGB 80803 trial, 5-year OS for the induc...

Not sure why this patient received neoadjuvant chemoimmuno if, as the vignette stated, they weren't a good surgical candidate. Isn't that the basis for induction systemic therapy alone? Prior studies have demonstrated that sequential chemo followed by chemoRT is more toxic, yet not more effective th...