Would you use radiotherapy (including SBRT) in a patient with locally advanced pancreatic cancer who has multiple cystic structures in the pancreatic head on imaging, possibly due to pancreatic leak, but is asymptomatic?  

Possible pancreatic leaks would not change my treatment recommendations. Pre-op chemoradiation has been reported to reduce the incidence of PJ leaks by reducing the exocrine output (Lowy et al., PMID 9389397), so it could be helpful if that is what is causing the cysts.