Would you consider offering neoadjuvant concurrent chemoradiation to a young (<50) patient with adenocarcinoma of the GE junction with a site of solitary metastasis (bone)?   

In general, my approach to the patient with a solitary site of metastasis from GE junction cancer is to start with chemotherapy.  If their disease is responsive over a few scans, it’s reasonable to then “consolidate” with chemoradiotherapy to the primary tumor site. If progre...