Hypofractionated ablative radiation therapy before surgery improves overall survival in locally advanced pancreatic cancer.

• 38% overall survival at 2 years; 54% for those who underwent resection.
• Only 11% local progression and 73% distant metastasis rates at 2 years.

This strategy shows no increase in surgical morbidity, making it significant for patient selection and preoperative planning in LAPC.

• 94% of participants received mFOLFIRINOX, highlighting effective induction therapy prior to radiation.