What is your radiation approach to metastatic pancreatic tail adenocarcinoma s/p gem/abraxane and FOLFIRI now with an oligo-progressive LUL lung metastasis?

I certainly would favor metastasis-directed therapy with SBRT, given the PFS benefit observed in EXTEND, and I think the case for utilization in the oligoprogressive state is even stronger pan-tumor compared to consolidative treatment. I'd treat 50-55 Gy/5 fractions or could consider fractionating o...

Ablative RT 10 Gy x 5 (MRgRT) or 67.5 Gy in 15 fx (Linac) to primary + SBRT to the met. Patients with lung only mets have more indolent metastatic disease. Tail primary tumor progression does not cause as much morbidity as head lesions, so QOL benefit may be lower, and OS benefit is not clear; howev...