Stereotactic body radiation therapy (SBRT) for pancreatic and non-hepatobiliary gastrointestinal (GI) malignancies

In this review article, we review the current literature addressing the use of stereotactic body radiation therapy (SBRT) in non-hepatobiliary gastrointestinal malignancies. For many gastrointestinal malignancies, the desire to treat large fields encompassing nodal drainage and micrometastatic disease has precluded the use of stereotactic body radiation therapy for most definitive cases. However, the use of SBRT in locally advanced pancreatic cancer (LAPC) as well as in the treatment of metastatic abdominal lymph nodes has shown excellent local control rates. In carefully selected patients, local control in LAPC has been achieved with SBRT with minimal side effects. Toxicity in these patients has most closely correlated with the dose and volume of irradiated duodenum and small bowel. Similar patterns of excellent local control with minimal side effects have also been seen in the treatment of abdominal lymph node metastases as well as gastric and rectal cancer recurrence.