Executive summary

This review examined studies published in the last 10 years about the advancement of radiotherapy in the treatment of locally advanced pancreatic cancer. Chemoradiation with PBT delivered a total dose 54–67.5 GyE in 25–33 fractions or 45–50 GyE in 10 fractions reported around 26 months median survival time with no grade 3 GI toxicity.  For LAPC, the current recommended treatment is still standard dose chemoradiation to 54 Gy in 30 fractions or SBRT to 25–33 Gy in 5 fractions. However, anticipated changes within the next several years may include dose escalation in the form of SBRT to 50 Gy in 5 fractions or ablative hypofractionation to 67.5 Gy in 15 fractions using an SIB technique, MRgRT, or charged particle therapy (such as proton therapy or carbon ion therapy).