Would you consider SBRT to a single nodal recurrence in a patient with previously treated metastatic GEJ adenocarcinoma s/p a complete response to systemic therapy followed by 37.5 Gy to the primary who was NED for 12 months up until this recurrence?

Tough case! I would consider reinitiation of systemic therapy at this time, given the relatively short interval since completion of prior RT as well as concern for short interval progression in other areas without systemic control. After ~4-6 months of systemic therapy, however, if no new sites of m...

Completely agree with systemic followed by consolidation. After upfront systemic, or if the patient refused additional systemic currently, I would favor 15 fractions with SBRT technique, assuming the node is relatively close to the stomach.