Description
Inclusion Criteria:
- * Pathologically confirmed primary squamous cell or adenocarcinoma of the esophagus that involves the mid, distal or esophagogastric junction. The cancer may involve the stomach up to 5 cm.
- * Endoscopy with biopsy
- * Stage T1N102, T2-3N0-2 according to the American Joint Committee on Cancer (AJCC) 7th edition staging, based upon the following minimum diagnostic work-up:
- History/physical examination with documentation of patient's weight within 30 days of registration
- Chest/Abdominal/Pelvic contrast CT within 56 days of registration
- Whole body PET/CT within 56 days of registration
- Endoscopic ultrasound
- Patients may have regional adenopathy including para-esophageal, gastric, gastroheptaic and celiac nodes. If celiac adenopathy present, it must be ≤ 2cm.
- Patients with tumors at the level of the carina or above should undergo bronchoscopy to exclude fistula
- Pulmonary function test (including routine spirometry and DLCO) within 60 days prior to registration
- Serum creatinine ≤ 2 x the upper limit of normal within 4 weeks of registration
- Na, K, BUN, Glucose within 4 weeks prior to registration
- CBC/differential within 4 weeks prior to registration with adequate bone marrow function, defined as follows:
- * Absolute neutrophil count (ANC) ≥ 1,500 cells/mm3
- * Platelets ≥ 100,000 cell/mm3
- * Hemoglobin ≥ 8.0 g/dl (Note: the use of transfusion or other intervention to achieve Hgb ≥ 8.0 is acceptable.)
- Adequate liver function, defined as total bilirubin ≤ 1.5 x upper limit of normal, AST ≤ 3 x the upper limit of normal within 4 weeks of registration
- Age ≥ 18
- Zubrod performance status 0-2 within 4 weeks of registration
- Surgical consultation to confirm that patient will be able to undergo curative resection after completion of PCT prior to registration
- For women of childbearing potential, a negative serum pregnancy test within 14 days prior to registration
- Women of childbearing potential and male participants must practice adequate contraception while on study
- Patient must sign study specific informed consent prior to study entry
Exclusion Criteria:
- Patients with cervical esophageal carcinoma
- Patients with T1N0 disease and T4 disease
- Prior radiation for esophageal cancer or prior chest radiotherapy
- Prior chemotherapy for esophageal cancer
- Evidence of tracheoesophageal fistula or invasion into the trachea or major bronchi
- Prior invasive malignancy (except non-melanomatous skin cancer), unless disease free for a minimum of 2 years ( e.g. carcinoma in situ of breast, oral cavity, or cervix are permissible)
- Prior radiotherapy that would results in overlap of radiation fields
- Medical contraindications to esophagectomy
- Prior allergic reaction to paclitaxel or carboplatin
- Severe, active co-morbidity that may impact survival
- Pregnancy, nursing women, or women of child bearing potential, and men who are sexually active and not willing/able to use medically acceptable forms of contraception
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Ages Eligible for Study:
18 Years to N/A (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
No