Emergence of SBRT in borderline resectable pancreatic cancer: Is it the way forward?

Pancreatic cancers are aggressive cancers with poor survival outcomes and few effective treatment modalities. The previously used protracted chemo-radiotherapy (CTRT) regimens have not had encouraging results. Stereotactic body radiotherapy (SBRT) has shown encouraging results in the treatment paradigm of borderline resectable pancreatic cancers. Though body of level I evidence is weak currently, studies have shown better resectability with negative margins with neoadjuvant SBRT. Precise contouring, good image guidance, strict quality assurance, and multi-disciplinary spatial co-operation are crucial for its success. High biologically effective dose, smaller margins, short duration of treatment, and strategic sequencing are the key to better outcomes.