Proton Therapy for Esophageal Cancer

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…