Would irreversible elctroporation (IRE) performed at the time of Whipple affect your plans or dose for radiation in the setting of adjuvant treatment for pancreatic adenocarcinoma?

IRE is an ablative modality that is more selective for tumor than thermal ablation. There are at least 2 high volume centers (Louisville and Miami) that have reported interesting long term survival in locally advanced pancreatic cancer. During their learning curve, there were multiple grade 5 complications, so the safety is a legitimate question. Surgeons also are using it to ablate the margin intraoperatively. My feeling is that we should not use radiation after IRE because the safety is not established and if we do, we cannot evaluate the outcomes with IRE. Ablative radiation can often more easily be used in many of these cases if there is an isolated recurrence, since the duodenum is gone.