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Life sciences · Journal article
Frontiers in Oncology · September 7, 2026
A consensus or society position rather than new primary data.
This narrative review of 186 studies synthesizes evidence on stereotactic body radiotherapy (SBRT) for oligometastatic pancreatic ductal adenocarcinoma, concluding that SBRT has evolved from palliation to a disease-modifying component of multidisciplinary care. Available evidence is predominantly retrospective, reporting 1-year local control rates of 70–80% for pancreatic primaries and median overall survival of 12–18 months after SBRT-based consolidative therapy. The authors identify emerging biomarkers and advanced technologies as promising but emphasize that prospective, randomized, pancreas-specific trials incorporating biomarker-driven selection are essential before the optimal clinical role can be defined.
Narrative review with systematic domain examination. English-language studies addressing pancreatic ductal adenocarcinoma, oligometastases, and stereotactic body radiotherapy published January 2000–May 2026.. Intervention: Stereotactic body radiotherapy (SBRT) in oligometastatic pancreatic cancer, alone or as consolidative therapy; emerging biomarkers and advanced technologies (MR-guided adaptive SBRT, proton therapy) examined..
1-year local control rates of 70–80% for pancreatic primary tumors after SBRT 1-year local control rates of 85–95% for lung metastases after SBRT 1-year local control rates >95% for lymph node metastases after SBRT
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Clinicians should recognize SBRT as a potential disease-modifying component of multidisciplinary care for oligometastatic PDAC, though current evidence base is primarily retrospective. Patient selection frameworks and optimal sequencing with systemic therapy require prospective validation before SBRT can be standardized in this setting, similar to its established role in oligometastatic lung and prostate cancer.
Narrative review synthesizing evidence on SBRT in oligometastatic PDAC across six clinical domains, providing recommendations for multidisciplinary integration despite acknowledged paucity of randomized evidence.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize SBRT as a potential disease-modifying component of multidisciplinary care for oligometastatic PDAC, though current evidence base is primarily retrospective. Patient selection frameworks and optimal sequencing with systemic therapy require prospective validation before SBRT can be standardized in this setting, similar to its established role in oligometastatic lung and prostate cancer.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Oligometastatic pancreatic ductal adenocarcinoma (PDAC) may benefit from aggressive multidisciplinary therapy, yet the role of stereotactic body radiotherapy (SBRT) remains controversial and frameworks for patient selection remain incompletely defined. While SBRT has become a standard option in oligometastatic lung and prostate cancer, its application in PDAC faces unique challenges related to tumor biology, anatomic constraints, and a paucity of randomized evidence. This narrative review searched PubMed, Embase, and Cochrane Library (January 2000–May 2026) for English-language studies addressing PDAC, oligometastases, and SBRT. Of 1,247 records screened, 186 studies were included. Six domains were systematically examined: patient selection integrating clinical, molecular, and metabolic imaging biomarkers; pancreas-specific SBRT technical considerations including dose-fractionation and organ-at-risk constraints; systemic therapy integration and sequencing; clinical outcomes and progression patterns; quality-of-life evidence; and ongoing prospective clinical trials. Available evidence from predominantly retrospective series suggests 1-year local control rates of 70–80% for pancreatic primary tumors, 85–95% for lung metastases, and >95% for lymph node metastases, with median overall survival of 12–18 months after SBRT-based consolidative therapy. Emerging biomarkers—including ctDNA dynamics, KRAS mutational subtypes, and transcriptomic classifiers—and advanced technologies such as MR-guided adaptive SBRT and proton therapy show promise for improving the therapeutic ratio. The TREX1/cGAS-STING axis provides a mechanistic rationale for combining SBRT with immune checkpoint inhibitors, though dedicated quality-of-life data remain absent from the literature. Radiotherapy in oligometastatic PDAC has evolved from a purely palliative modality to a disease-modifying component of multidisciplinary care. Prospective validation through pancreas-specific randomized trials incorporating biomarker-driven patient selection and patient-reported outcomes is essential to define the optimal role of SBRT in this setting. Fang Fang and Peng Zhen contributed equally and are co-corresponding authors. Jiarui Zhang and Siming Shi contributed equally to this work.
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