NCCN Guidelines for Patients® | Esophageal Cancer - page 52

52
NCCN Guidelines for Patients
®
: Esophageal Cancer
Version 1.2013
Part 5: Squamous cell carcinomas
5.4 Recurrence of carcinoma
This chart maps the treatment options for cancer
that returned during follow-up testing. Options are
based on where the cancer returned. If there are no
distant metastases (M0 disease), the cancer can be
treated with concurrent chemoradiation if you didn’t
have chemoradiation before. The recommended
chemotherapy regimens for chemoradiation are:
Preferred regimens
• Cisplatin and fluoropyrimidine (5-FU or
capecitabine)
• Oxaliplatin and fluoropyrimidine (5-FU or
capecitabine)
• Paclitaxel and carboplatin
Other regimens
• Paclitaxel and cisplatin
• Docetaxel and cisplatin
• Irinotecan and cisplatin
• Paclitaxel and fluoropyrimidine (5-FU or
capecitabine)
• Docetaxel and fluoropyrimidine (5-FU or
capecitabine)
Other options include surgery, chemotherapy, or
supportive care. If the cancer returns as M0 disease
after chemoradiation with no prior esophagectomy, your
doctor will assess if you can have surgery and if the
tumor can be removed. If not, supportive care should
be given. Supportive care is also recommended for
distant metastases (M1 disease).
Next steps:
When you are finished with cancer
treatment, read Part 5.3 for follow-up testing.
If you will receive chemotherapy or supportive care,
read Part 5.5 next.
Recurrence site
M0 disease
M1 disease
Esophagectomy,
no chemoradiation
Chemoradiation,
no esophagectomy
Prior treatment
Chemoradiation,
Surgery,
Chemotherapy, or
Supportive care
Esophagectomy, or
Recurrence
treatment
Supportive care
Supportive care
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