Would you consider SBRT or more conventionally fractionated radiation for an in-field mediastinal recurrence of esophageal adenocarcinoma s/p preoperative CRT, esophagectomy, and now progressing on immunotherapy?

Topics: Radiation Oncology • Gastrointestinal Cancers • Esophageal Cancer

How would your decision differ if the patient was not on immunotherapy or other systemic therapy? Would your thinking differ depending on the timing of the recurrence?

Answer from: Radiation Oncologist at Academic Institution

Hard question – many variables (and answers). I think the timing of recurrence and overlap/proximity to central structures (and extent of overlap to prior RT) biggest determinants of fractionation and whether to offer RT at this junction (i.e., if ‘ultra-central’ location, would ce...

Comments

Radiation Oncologist at Munson Medical Center
Dr. @Atkins brings up all the relevant consid...

Radiation Oncologist at Fox Chase Cancer Center
I agree with Dr. @Atkins Atkins and Dr. @Forster. ...

Radiation Oncologist at University of Nebraska Medical Center
Great discussion. I don't usually re-irradiate the...

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