Pancreatic cancer is the third leading cause of cancer death in the developed world and is predicted to become the second by 2030. A cure may be achieved only with surgical resection of an early diagnosed disease. Surgery for more advanced disease is challenging and can be contraindicated for many reasons. Neoadjuvant therapy may improve the probability of achieving R0 resection. It consists of systemic treatment followed by radiation therapy applied concurrently or sequentially with cytostatics. A novel approach to irradiation, stereotactic body radiotherapy (SBRT), has the potential to improve treatment results. SBRT can deliver higher doses of radiation to the tumor in only a few treatment fractions. It has attracted significant interest for pancreatic cancer patients, as it is completed quickly, requires less time away from full-dose chemotherapy, and is well-tolerated than conventional radiotherapy. In this review, we aim to provide the reader with a basic overview of current evidence for SBRT indications in the treatment of pancreatic tumors. In the second part of the review, we focus on practical information with respect to SBRT treatment plan preparation the performance of such therapy. Finally, we discuss future directions related to the use of magnetic resonance linear accelerators.

Department of Comprehensive Cancer Care Masaryk Memorial Cancer Institute Zluty Kopec 7 656 53 Brno Czech Republic

Department of Gastroenterology and Digestive Endoscopy Masaryk Memorial Cancer Institute Zluty Kopec 7 656 53 Brno Czech Republic

Department of Gastroenterology University Hospital Brno Jihlavska 340 20 625 00 Brno Czech Republic

Department of Hematology Oncology and Internal Medicine University Hospital Brno Jihlavska 340 20 625 00 Brno Czech Republic

Department of Radiation Oncology Masaryk Memorial Cancer Institute Zluty Kopec 7 656 57 Brno Czech Republic

Faculty of Medicine Masaryk University Kamenice 753 5 625 00 Brno Czech Republic

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