The use of radiotherapy in treating inoperable pancreatic cancer is a controversial topic, with conventionally fractionated irradiation (1.8-2.0 Gy/fraction) combined with concurrent chemotherapy demonstrating equivocal survival results in 5 phase 3 randomized clinical trials.1-5 The contemporary LAP07 trial, in contrast to the older randomized trials, used smaller radiation fields that were limited to gross disease plus margin (54 Gy in 1.8 Gy fractions) in combination with capecitabine following 4 months of gemcitabine chemotherapy with or without erlotinib.3 While median overall survival was not improved by the addition of conventional chemoradiotherapy (16.5 vs 15.2 months; P = .08), the use of chemoradiotherapy was associated with significantly reduced rates of local disease progression (32% vs 46%; P = .03), longer time without receiving chemotherapy (6.1 vs 3.7 months; P = .02), and a trend toward improved progression-free survival (hazard ratio, 0.78; P = .06). This lack of overall survival benefit from long-course conventional radiation, coupled with technological improvements in the planning and delivery of radiation, has led to the use of stereotactic body radiotherapy (SBRT) in select patients with inoperable pancreas cancer.