The American Society for Radiation Oncology (ASTRO) is the...

The American Society for Radiation Oncology (ASTRO) is the world’s largest radiation oncology society, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies - have published their guidelines for radiotherapy in pancreatic cancer.

Recommendations on the indications of radiation therapy for pancreas cancer are as follows:

In the adjuvant/post-operative setting, conventionally fractionated radiation is recommended conditionally for patients with high-risk features such as positive lymph nodes and margins following surgical resection. SBRT is recommended only if the patient is enrolled in a clinical trial/data registry.

In the neoadjuvant/pre-operative setting, conventionally fractionated radiation therapy or SBRT is recommended conditionally following chemotherapy for patients with resectable disease.

Neoadjuvant chemotherapy plus radiation (either conventional or stereotactic) is conditionally recommended following systemic therapy for select patients with borderline resectable disease.For patients with locally advanced disease (who are not candidates for surgery), systemic chemotherapy followed by either chemoradiation or SBRT is recommended conditionally as an option for definitive treatment.

So the leading society does not recommend radiotherapy alone in any of its combinational treatment guidelines.

This would suggest that asking for a control only radiotherapy arm for oncosil is obtuse and would not be accepted by the leading raditiotherapy communities.

What oncosil is trying to do is offer an alernative solution to external beam radiotherapy and increase outcomes for resection. Surgical resection and local disease control are different aims but can overlap. Surgical resection is the only aim for complete cure.