Patients diagnosed with pancreatic cancer, metastatic, candidate for first-line treatment standard systemic; either newly diagnosed in metastatic stage or first progression to metastasis.
Obtaining informed consent
Patients \>18 years of age
ECOG 0-2
Performance of imaging (CT with mdc, MRI with mdc, CT-PET with appropriate tracer) adequate for baseline local and systemic staging and likely to be similarly repeatable at 6 and 12 months after randomization
Confirmation at the time of randomization, by the Radiotherapy Center, that it is possible to perform all treatments potentially planned for the patient (if enrolled in experimental arm) within a maximum of 25 total days prior to referral to the Medical Oncology Center for systemic therapy
You may not be if
Metastatic picture of line subsequent to the first
Technical or organizational impracticality to the eventual termination of radiation treatments Within 25 days after randomization
Inability to express independent consent to treatments
Pregnancy
Patient in hospice or with prognosis \< 6 months
Predicted unavailability for follow-up at 6 months
Absence of adequate or likely non-repeatable pretreatment imaging study at 6 and 12 months
Previous radiation therapy
Previous radiometabolic therapy
Inability to maintain treatment position for SBRT
Symptomatic emergent or other presentation precluding study development as planned (e.g., epidural compression of the spinal cord or cauda equina)
Previous chemotherapy, immunotherapy or target therapy
