When treating borderline resectable pancreatic adenocarcinoma patients with neoadjuvant chemoradiation, do you treat the elective nodal regions or the primary alone?

This is a very reasonable question without a clear answer, and I'd be interested in seeing how other people respond.

As I've mentioned in a previous pancreatic cancer discussion on this forum, there are ongoing trials to evaluate whether radiation improves outcome in the resectable setting (RTOG 084...

This is a very good and timely question. I think it also may be rephrased as “what is the ideal target volume for neoadjuvant RT in borderline resectable pancreatic cancer?” The lesser discussed issue when this question is raised is the very high rate of perineural spread for pancreatic cancers ...