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Hey #GIOnc #Radonc friends! Let’s talk definitive CRT for locally advanced esophagus cancer! Looks like we now have at least 5 RCTs exploring dose escalation… and the standard remains 50 Gy! Let’s review!! 🧵🧵🧵1/ 
RTOG 8501 established the standard care of 50.4 Gy + concurrent chemotherapy for patients with inoperable, locally advanced esophagus cancer
Nearly 90% were SCC.
🔵Long-term disease control/survival was achieved in approximately 25% of patients. 0% with RT alone!!! 2/
Nearly 90% were SCC.
🔵Long-term disease control/survival was achieved in approximately 25% of patients. 0% with RT alone!!! 2/
However, local progression after 50.4 Gy + chemo occurs in approximately 50% of patients AND the vast majority occur at sites of initial gross disease. Hence the question: Would increasing RT dose improve outcomes??? 3/
