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?

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 certainly consider h...