patient care perspectives

Stereotactic Body Radiotherapy (SBRT) in Patients With Locally Advanced Pancreatic Cancer

by Alok Khorana, MD


SBRT is an effective approach to local tumor control with limited toxicity in patients with metastatic pancreatic cancer. Given the favorable toxicity profile of SBRT, it can be combined with other therapies in patients with pancreatic cancer at all stages of disease. Studies have demonstrated that SBRT leads to improvements in patient-reported quality of life and cancer-related pain. SBRT has also been recommended as a treatment choice for patients with metastatic pancreatic cancer with poor performance status.

Expert Commentary

Alok Khorana, MD

Professor of Medicine
Director, Gastrointestinal Malignancies Program
Cleveland Clinic
Cleveland, OH

SBRT is an additional treatment approach that is being recommended by radiation oncologists for patients with locally advanced pancreatic cancer. SBRT is commonly recommended for patients who have had a great response to treatment ‒ or at least good disease control with treatment ‒ but are unable to stay on treatment for toxicity reasons. In those patients, using SBRT on the primary lesion can be helpful in further obtaining disease control and allowing patients with treatment toxicity from chemotherapy to hopefully stay off of systemic treatment for longer periods of time.

"SBRT is commonly recommended for patients who have had a great response to treatment ‒ or at least good disease control with treatment ‒ but are unable to stay on treatment for toxicity reasons.”

Alok Khorana, MD


Lischalk JW, Burke A, Chew J, et al. Five-fraction stereotactic body radiation therapy (SBRT) and chemotherapy for the local management of metastatic pancreatic cancer. J Gastrointest Cancer. January 3, 2017. doi: 10.1007/s12029-016-9909-2. [Epub ahead of print]

Park JJ, Hajj C, Reyngold M, Shi W, Zhang Z, Cuaron JJ, et al. Stereotactic body radiation vs. intensity-modulated radiation for unresectable pancreatic cancer. Acta Oncol. June 29, 2017:1-8. doi: 10.1080/0284186X.2017.1342863. [Epub ahead of print]

Rosati LM, Kumar R, Herman JM. Integration of stereotactic body radiation therapy into the multidisciplinary management of pancreatic cancer. Semin Radiat Oncol. 2017;27(3):256-267.

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