Radiation therapy in the treatment of pancreatoblastoma: a narrative review.

Pancreatoblastoma is an extremely rare pediatric pancreatic tumor that primarily affects children <10 years of age, with a mean age of onset of 5 years. Risk factors such as vascular and lymph node involvement often lead to incomplete resection, necessitating a multidisciplinary approach. Despite these strategies, the role of radiotherapy in the management of pancreatoblastoma remains unclear. A quantitative literature search of the PubMed database was performed to identify relevant case reports and series that explicitly documented the use of radiotherapy for pancreatoblastoma. The search covered the period from January 1986 to November 2024. Of the 36 records retrieved, seven case reports comprising eight patients fulfilled the inclusion criteria. Six patients underwent radiotherapy at the primary tumor site with external beam therapy doses ranging from 36 to 46.2 Gy. Intraoperative radiotherapy was also administered in two cases, with doses of 15 and 20 Gy. Additionally, stereotactic radiotherapy was administered to two patients with intracranial metastases, demonstrating its effectiveness in managing brain metastases. Although the role of radiotherapy in pancreatoblastoma remains ambiguous, it demonstrates promise in cases of incomplete resection, recurrence, or non-resectable disease. However, pediatric patients require careful consideration because of potential long-term side effects. Further research is required to optimize radiotherapy protocols and integrate emerging therapies.