Info

🌱來自: esophageal cancer

Treatment of esophageal cancer

(NCCN Guidelines v5.2021 Gastric & v4.2021 Esophageal)

• If localized disease and good performance status/fit, goal is cure with surgery
• Localized: resection. Periop or neoadjuvant chemo/chemoRT if stage IB or higher (NEJM 2012;366:2074). Adjuvant nivolumab (NEJM 2021;384:1191).
• Advanced: sequential chemo w/ platinum/fluoropyrimidine (+ trastuzumab if HER2⊕, + nivolumab if PD-L1⊕), ramucirumab (VEGF, 2nd line), nivolumab/pembrolizumab (PD-1, 3rd line)
• Supportive care: pain/nausea mgmt. Consider G/G-J tube if obstruction, IVF prn.