How would you approach a patient with locally recurrent esophageal carcinoma who is s/p previous chemoRT and refuses salvage surgery?   

There is little data to guide treatment in this situation and well founded fear of toxicity with repeat radiation. In a recent report from China, patients with locoregional recurrence after definitive treatment that involved RT had impressively longer OS with repeat RT to a median dose of 50 Gy. The...