What radiation strategy do you use in clinically node positive pancreas cancer responding to neoadjuvant chemotherapy?

For locally advanced disease or any situation where the surgery is not a definite option, we recommend ablative radiation (100Gy BED equivalent). That includes an ablative dose to the GTV imbedded within a microscopic dose PTV that includes wide coverage for microscopic extension to nodes along vessels, and direct extension. The presence of enlarged nodes does not change anything, we treat them with an ablative dose as well. Further details of that treatment are found in multiple other posts on ...