Local ablation in pancreatic cancer: some answers and more questions
There is no consensus on how to treat patients with locally advanced pancreatic cancer beyond systemic chemotherapy. A minority of patients will respond well and become candidates for surgical resection, and many will die from distant disease progression. Patients not suitable for resection but without distant spread cannot stay on systemic therapy indefinitely due to toxicity, which drives demand for locoregional options. Despite their widespread use, neither conventional radiotherapy nor higher dose stereotactic ablative body radiotherapy (SABR) has been proven to improve overall survival in locally advanced pancreatic cancer.