Patient-reported outcomes are very important. They have to be taken in the context of all toxicities and physician-reported toxicity events as well, but they’re very, very important. It matches our clinical experience that patients getting SBRT tend to feel better. They tended to be in the hospital less [often]. They were at home with family more [often]. They were doing more normal daily activities. They were able to be outside enjoying themselves as opposed to coming in for treatment every day, so there’s probably a significant element associated with that. They also did not receive concurrent chemotherapy with SBRT, so that might have lightened the burden and the potential toxicities, such as the hematologic toxicities and other things that can occur with the administration of chemotherapy as part of conventionally fractionated chemoradiation.
Time is a very important element here. When we give patients more of their time and we prevent them from having to come to the hospital every day, Monday through Friday, for 5 and a half weeks, there could potentially be benefits associated with that.
The other element that was quite unique about our study, and different from other studies that have applied SBRT, is that we did adaptive MRI-guided SBRT in most of the patients who had SBRT. Of the just over 50 patients who had SBRT, the majority received adaptive MRI guidance. We used an MRI linear accelerator. We recontoured their tumors each day, and we recontoured their normal structures. While we did not test this, that precision, daily adaptation, and daily accuracy may have had something to do with the preservation of their quality of life and function.
Reference
Hall WA, Tsai S, Banerjee A, et al. A randomized, phase II clinical trial of stereotactic body radiation therapy or conventionally fractionated concurrent chemotherapy and radiation therapy preoperatively for pancreatic adenocarcinoma, the SOFT Preop study. Presented at: 2026 ASTRO Annual Meeting; September 26–30, 2026; Boston, MA. Abstract LBA 08.
