In our last two episodes, we focused on patients with resectable or borderline resectable pancreatic cancer—those for whom surgery is the ultimate goal. Today, we turn to a different, but equally challenging scenario: the patient with locally advanced, unresectable disease. These are the patients whose tumors are intimately involved with the major blood vessels, taking surgery off the table, but who do not yet have distant metastases. Here, the goals shift from cure to long-term control. This is where radiation therapy, particularly SBRT, has seen its most significant evolution. This is our SBRT masterclass: we’ll cover the data for conventional chemoradiation, justify ablative SBRT doses, and tackle the critical controversy of how to define our target volumes.

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