Pancreas Cancer

The use of radiation therapy (RT) for pancreatic cancer was historically controversial. Randomized trials of conventionally fractionated chemoradiation in the postoperative and definitive settings have shown improvements in local control but not overall survival. However, treatment for all patients with nonmetastatic pancreatic cancer is shifting toward total neoadjuvant therapy, and the PREOPANC randomized trial recently showed an overall survival benefit for preoperative chemoradiation [1]. In addition, technological advances now allow the delivery of high, potentially ablative radiation doses while maintaining safe bowel limits. In this chapter, we will discuss the use of hypofractionated RT (including SBRT) for pancreatic cancer.