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Everyone knows, even with increasing technical successes of local therapies, systemic therapy is the name of the game for pancreatic cancer. On the flip side, even with landmark successes with regimens like mFOLFIRINOX, close and/or positive margin resections occur in nearly half of cases, leaving a lot of room for local improvement. Here is a presentation of quite the interesting concept: sandwiching neoadjuvant stereotactic radiation amidst chemo to neither delay initiation of chemo nor waste time off chemo while letting radiation do its thing before surgery. In another turn from evolving norms, it proposes that radiation volumes include elective adjacent nodes taken to lower doses using a simultaneous integrated boost approach, not only for the obvious reason, but also to minimize marginal misses in what would otherwise be severe dose gradients. | Ryckman, Clin Transl Radiat Oncol 2021


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