Would you offer a palliative or more aggressive course of radiation therapy for a symptomatic isolated supraclavicular recurrence of a squamous cell carcinoma of the esophagus?

Topics: Radiation Oncology • Gastrointestinal Cancers • Esophageal Cancer • Medical Oncology

What would your approach be in a patient with a mid-esophageal squamous cell carcinoma treated with chemoradiation therapy followed by surgery, with PET showing a new, large supraclavicular lymph node 2 months after surgery? The patient is also planned for immunotherapy.

Answer from: Radiation Oncologist at Community Practice

Such early disease progression suggests there was likely occult involvement of the supraclavicular lymph node at the time of initial diagnosis. My decisions on management would hinge upon the extent of initial CRT field.If the supraclavicular lymph node was in field, I would favor a systemic treatme...

Comments

Radiation Oncologist at Fort Bend Medical and Diagnostic Center
Thank you!

Answer from: Radiation Oncologist at Academic Institution

Before I decide on how to manage the patient, I would want to know the following: In retrospect, was there a supraclavicular node on the radiation planning CT that could be deemed responsible for the new recurrence/progression? What chemoradiation regimen was given to the patient, in...

Answer from: Radiation Oncologist at Academic Institution

Palliative.

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