NBTXR3, Chemotherapy, and Radiation Therapy for the Treatment of Esophageal Cancer

Prior treatment

• Prior radiation or any therapy for the treatment of esophageal cancer
• Prior surgical resection of esophageal tumor

Other illness

• Esophageal cancer with radiographic evidence of metastases at screening
• At screening, past medical history of:
  • Esophageal fistula
  • Tracheoesophageal fistula
  • Siewert type III tumors
• Evidence of bulky disease and/or abutment of tumor above the carina that may result in tracheoesophageal fistulas as determined by the investigator or treating physician
  • Tumors above the carina without defacement of the fat plane between tumor and the airway are allowed
• Known uncontrolled (grade \>= 2) or active esophageal or gastric ulcer disease within 28 days of enrollment
• Active malignancy, in addition to esophageal cancer except for basal cell carcinoma of the skin or non-metastatic low risk prostate cancer definitively treated and relapse free within at least 3 months from time of screening
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, renal failure, cardiac arrhythmia, or psychiatric illness that would limit compliance with treatment
• Known active, uncontrolled (high viral load) human immunodeficiency virus (HIV) or hepatitis B or hepatitis C infection
• Women of child-bearing potential and their male partners who are unwilling or unable to use an acceptable method of birth control to avoid pregnancy for the entire study period. Acceptable methods of contraception are those that, alone or in combination, result in a failure rate of \< 1% per year when used consistently and correctly
• Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (e.g., compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments

Other

• Known contraindication to iodine-based or gadolinium-based intravenous (IV) contrast
• Female patients who are pregnant or breastfeeding

• Biopsy proven adenocarcinoma of the cervical or thoracic esophagus or gastroesophageal junction
• Adenocarcinoma of the esophagus stages II-III allowed
• Medically able to receive chemoradiation. Following chemotherapy regimens are allowed:
  • Oxaliplatin and fluorouracil (5-FU) or capecitabine
  • Docetaxel and/or 5-FU or paclitaxel
  • Carboplatin and paclitaxel
• Amenable to undergo the endoscopic ultrasound (EUS) guided injection of NBTXR3 as determined by the investigator or treating physician
  • Patients with lesions for which the EUS scope is not able to traverse the tumor are allowed on this trial as long as an injection can be performed as per treating physician's discretion
• Has at least 1 and up to 4 target lesion(s) in the esophagus that are measurable on cross sectional imaging and repeated measurements (via Response Evaluation Criteria in Solid Tumors \[RECIST\] version \[v\] 1.1) at the same anatomical location should be achievable
  • Local nodal disease around the esophagus allowed
  • Nodal target lesions must be \>= 15 mm (short axis) based on computed tomography (CT) (slice thickness of 5 mm or less) or magnetic resonance imaging (MRI)
• Eastern Cooperative Oncology Group (ECOG) performance status 0-2
• Hemoglobin \>= 8.0 g/dL
• Absolute neutrophil count (ANC) \>= 1,500/mm\^3
• Platelet count \>= 100,000/mm\^3
• Creatinine =\< 1.5 x upper limit of normal (ULN)
• Calculated (Calc.) creatinine clearance \> 30 mL/min
• Glomerular filtration ratio \> 40 mL/min per 1.73 m\^2
• Total bilirubin =\< 2.0 mg/dL
• Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 2.5 x upper limit of normal (ULN)
• Negative urine or serum pregnancy test =\< 7 days of NBTXR3 injection in all female participants of child-bearing potential
• Signed informed consent form (ICF) indicating that participant understands the purpose of, and procedures required for, the study and is willing to participate in the study