Surgery Versus Stereotactic Ablative Radiotherapy for Patients With Locally Advanced Pancreatic Cancer With Favourable Biological Response Following Induction Chemotherapy

The current evidence on the added survival benefit of surgery after induction chemotherapy is limited by strong selection bias, and international guidelines state that the longterm survival benefit of surgery in locally advanced pancreatic carcinoma (LAPC) remains uncertain. In parallel, stereotactic ablative radiotherapy (SABR), particulary MRI guided SABR, had emerged as a promising less invasive alternaitve, achieving high local control rates with limited toxicity. Therefore, this international, multicentre, open-label, phase 3 superiority randomized clinical trial assesses whethersurgery improves overall survival as compared to MRI-guided SABR. Primary objective is overall survival, secondary objectives include evaluation of failure free survival, quality of life, and serious adverse events.