NCCN Guidelines for Patients® | Esophageal Cancer - page 68

NCCN Guidelines for Patients
: Esophageal Cancer
Version 1.2013
Part 6: Adenocarcinomas
see or cancer was found in distant sites, chemoradiation
or supportive care are options. The recommended
chemotherapy regimens for chemoradiation after surgery
• 5-FU before, during, and after radiation,
• 5-FU before and after radiation with capecitabine,
• Capecitabine before and after radiation with 5-FU, and
• Capecitabine before, during, and after radiation.
Next steps:
When you are finished with cancer
treatment, read Part 6.3 for follow-up testing. If you will
receive supportive care, read Part 6.5 next.
TNM scores
Primary treatment
T4b, N+, M0
No signs of cancer
T1 – T4a disease
T4b or M1 disease
Adjuvant treatment
Supportive care
Esophagectomy, or
Supportive care
T4b tumors
Start follow-up testing
This chart maps the course of treatment for T4b tumors.
These tumors can’t be first treated with surgery even
if you are able to undergo surgery. Instead, concurrent
chemoradiation to cure the cancer is recommended.
The recommended chemotherapy regimens for
chemoradiation are:
Preferred regimens
• Cisplatin and fluoropyrimidine (5-FU or capecitabine)
• Oxaliplatin and fluoropyrimidine (5-FU or
• Paclitaxel and carboplatin
Other regimens
• Paclitaxel and cisplatin
• Docetaxel and cisplatin
• Irinotecan and cisplatin
• Paclitaxel and fluoropyrimidine (5-FU or
• Docetaxel and fluoropyrimidine (5-FU or
How the tumor responds to treatment will be assessed
with a CT scan with contrast, PET/CT, or upper GI
endoscopy. These tests are described in Parts 2.1 and 3.1.
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