NCCN Guidelines for Patients® | Esophageal Cancer - page 62

62
NCCN Guidelines for Patients
®
: Esophageal Cancer
Version 1.2013
Part 6: Adenocarcinomas
This chart maps one course of treatment for people
healthy enough for surgery. First, concurrent
chemoradiation is given to shrink the tumor.
The recommended chemotherapy regimens for
chemoradiation are:
Preferred regimens
• Paclitaxel and carboplatin
• Cisplatin and fluoropyrimidine (5-FU or capecitabine)
• Oxaliplatin and fluoropyrimidine (5-FU or
capecitabine)
Other regimens
• Irinotecan and cisplatin
• Docetaxel and fluoropyrimidine (5-FU or
capecitabine)
• Paclitaxel and fluoropyrimidine (5-FU or
capecitabine)
TNM scores
Results
No signs
of cancer
T1 – T4a
disease
T4b or M1
disease
Neoadjuvant
treatment
Chemoradiation, or
Primary treatment
Follow-up testing
Esophagectomy, or
Supportive care
Esophagectomy, or
Supportive care
Surgical options
Option 1
No cancer in
the margins or
lymph nodes
Start follow-up testing
Surgery
results
Adjuvant treatment
No cancer in
margins but in
lymph nodes
Observe until
cancer grows
Supportive care
M1 disease
was found
Some tumor
was left behind
Cancer is in
the margins
Observe until
cancer grows
T2, N0, M0
T3, N0, M0
T4a, N0, M0
T1b, N+, M0
T2, N+, M0
T3, N+, M0
T4a, N+, M0
1...,52,53,54,55,56,57,58,59,60,61 63,64,65,66,67,68,69,70,71,72,...100
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