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Evolving Multidisciplinary Management of Patients with Esophageal and Gastroesophageal Junction Cancer
The treatment landscape of esophageal and gastroesophageal junction cancer is evolving quickly with changes in the role of surgical management, emerging clinical data on the use of chemoradiation vs. perioperative systemic therapy for resectable patients, and mounting data on potential heart-related toxicity following radiation therapy. Failure to stay up to date can lead to inadequate counseling of patients and lower quality of care by practicing clinicians.
This activity provides education on the evolving treatment options for patients with esophageal/gastroesophageal junction cancer and recognizes the risk of cardiotoxicity in this patient population. The first speaker is a surgeon who focuses on the emerging data utilizing chemoradiation as a definitive therapy for esophageal cancer with surgery reserved for those with an incomplete clinical response or local regrowth and the challenges of such an approach. This speaker also highlights the ongoing trials investigating this clinical question. The second speaker highlights the potential for cardiotoxicity following thoracic radiation in patients with esophageal and gastroesophageal junction cancer and discusses identification and potential prevention measures. This speaker also covers practical information such as evidence-based heart and cardiac substructure dose constraints in radiation planning in addition to proton therapy for cardiac sparing. The third speaker is a medical oncologist who provides insight into the ongoing debate of neoadjuvant chemoradiation vs. perioperative systemic therapy for patients with localized and resectable esophageal and gastroesophageal junction cancer. The activity concludes with a brief clinical case review to highlight some of the discussion points in each of the talks.
Topics:
- Non-Operative Management of Esophageal and Gastroesophageal Junction Cancer: Ready for Prime Time?
Nicolas Contreras, MD - Cardiotoxicity Following Radiation Therapy in Patients with Esophageal and Gastroesophageal Junction Cancer
Jolinta Lin, MD - "FLOT or NOT" - Preoperative Chemoradiation vs. Perioperative Systemic Therapy for Resectable Esophagus and GEJ Cancers
Kelsey A. Klute, MD - Patient Cases and Discussion
Eric Miller, MD, PhD - Moderator
Randa Tao, MD - Moderator
Full Panel
This activity is available from August 19, 2025, through 11:59 p.m. Eastern time on August 18, 2027.
Target Audience
The activity is designed to meet the interests of medical oncologists, radiation oncologists, surgeons and residents.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Determine when non-operative management is appropriate for a patient with esophageal or gastroesophageal junction cancer and discuss the risks and benefits of such an approach. Describe ongoing studies addressing this clinical question.
- Discuss the potential risk of cardiotoxicity following radiation therapy for patients with esophageal and gastroesophageal junction cancer and identify potential prevention measures such as evidence-based dose constraints to use in clinical practice and when to consider a referral to a proton center.
- Discuss the use of chemoradiation vs. perioperative systemic therapy for patients with resectable esophageal and gastroesophageal junction cancer. Discuss the relevant clinical evidence when determining which treatment is appropriate for a patient.
- Randa Tao, MD, is employed by Mayo Clinic. Dr. Tao serves as Associate Section Editor for the Red Journal and also serves as an examiner/question writer for the American Board of Radiology.
- Eric Miller, MD, PhD, is employed by Ohio State University Comprehensive Cancer Center.
- Nicolas Contreras, MD, is employed by the University of Utah.
- Jolinta Lin, MD, is employed by Emory University. Dr. Lin owns a copyright and has ownership equity in Imagilin Technologies, LLC.
- Kelsey A. Klute, MD, is employed by University of Nebraska Medical Center. Dr. Klute receives compensation from Ipsen, BMS and Merus.
The person(s) above served as the developer(s) of this activity. Additionally, the ASTRO Education Committee had control over the content of this activity. All relevant financial relationships have been mitigated.
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Available Credit
- 1.25 AMA PRA Category 1 Credit™
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.25 Certificate of AttendanceThis activity was designated for 1.25 AMA PRA Category 1 Credit™.
Price
Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.
- Nonmember: $149
- Member: $99
- Member-in-Training: $49
- Student/Graduate Student/PGY-1 Member: $49
- Postdoctoral Fellow Member: $49
If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.
Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the activity by the expiration date.
Participants using ASTRO Academy activities to satisfy the requirement of a Continuing Certification (MOC) program should verify the credit number and type and availability dates of any activity before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased activities that do not align with their MOC requirement.
The activity and its materials will only be available on the ASTRO website until August 18, 2027, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date.
Required Hardware/software
One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.