Would you consider maintenance therapy for patients who achieve complete response after palliative chemoradiation for metastatic distal esophageal adenocarcinoma?

There isn’t much evidence in this setting. I definitely consider chemotherapy and radiation in patients with small burden metastatic esophageal adenocarcinoma if they have significant dysphagia. Chemotherapy and radiation in the end is the most effective way to palliate dysphagia. I do however also consider stents in these patients. If I did give the patient chemotherapy and radiation with carboplatin and paclitaxel and the patient achieved a nice response, I would likely give a few more cycles after that using the same regimen. Similarly if I treated the patient with cisplatin and 5fu I would perhaps continue with folfox. Don’t forget the HER2 status as you might consider adding herceptin to the chemo regimen following chemorads. I only co...