Would you offer re-irradiation in an adenocarcinoma of the distal esophagus s/p neoadjuvant chemoradiation + Ivor Lewis esophagogastrectomy (ypT3N0) 2 years ago now with TE groove/paraoesophageal LN recurrence with complete response on PET following 8 cycles of FOLFOX?

I generally would offer re-irradiation in this situation. If the lymph node recurrence is completely out of the prior field, it becomes an easier decision and much less technically complex in regard to radiation treatment planning. If out of field, I would treat with 50–50.4 Gy 25–28 fractions with ...

Due to the unlikelihood of R0 resection, and the relatively long interval with no metastatic disease and for recovery of tolerance, I would approach this patient with enthusiasm for rt-RT. Biology and technology both should be considered. After that, surgery should be considered. Re-RT will not work...