Chemoradiation in Locally Advanced Pancreatic Cancer

Inclusion Criteria:

• Patient must have newly diagnosed computated tomography (CT) and endoscopic ultrasound(EUS) stage Tx-4, N0-1, M0 adenocarcinoma of pancreas according to the American Joint Committee on Cancer (AJCC) staging system. The following cell types will NOT be eligible: adenosquamous carcinoma, ampullary carcinoma, carcinoid tumor, cystadenocarcinoma, cystadenoma, distal common bile duct carcinoma, duodenal carcinoma, or islet cell carcinoma
• Treatment must begin within 60 days of diagnosis
• Must have locally advanced inoperable pancreatic cancer with no metastatic spread as determined by a baseline diagnostic CT scan of the chest, endoscopic ultrasound and CT scan with intravenous (IV) contrast (or MRI) of abdomen/pelvis, within 30 days prior to registration.
• No prior systemic chemotherapy or radiation therapy for pancreatic cancer
• Documented Eastern Cooperative Oncology Group (ECOG/Zubrod) performance status 0-1 within 14 days prior to registration

• Adequate hematologic, renal and hepatic function as defined by the following laboratory values (completed within 14 days prior to registration)

  • white blood cell (WBC) > 3,000 mm3
  • absolute neutrophil count (ANC) > 1,500 mm3
  • platelet count ≥ 100,000 mm3
  • hemoglobin > 9.5 g/dl
  • serum creatinine < 1.5 times institutional upper limit of normal (ULN)
  • total bilirubin ≤ 3 mg/dl
  • AST (SGOT) < 4.0 times institutional ULN
  • ALT (SGPT) < 4.0 times institutional ULN
  • alkaline phosphatase < 2.0 times institutional ULN
• Age ≥ 18 years
• Life expectancy ≥ 12 weeks
• Patient (male or female) of reproductive potential are required to use a medically acceptable contraception during treatment and for 3 months after the last dose of chemotherapy.
• Not pregnant or breastfeeding since the drugs used in this study are Pregnancy Category D: Clear evidence of risk in pregnancy. A negative pregnancy test is required within 7 days of registration if pre- or perimenopausal (i.e., last menstrual period within one year of registration)

• If patient has a previous diagnosis of cancer, all of the following criteria must be met and documented in the patient's medical record:

  • Patient has undergone potentially curative therapy for all prior malignancies.
  • No evidence of prior malignancies for at least 5 years (except for successfully treated cervical carcinoma in situ, carcinoma in situ of the breast, or nonmelanoma skin cancer.
  • No evidence of recurrence of any prior malignancy.
• Patient who is receiving chronic immunotherapy (e.g. prednisone or methotrexate) for collagen vascular disease or other chronic immunologic abnormality are not eligible.
• Not requiring one or more of the contraindicated medications
• Patient must be able to understand the potential risks and benefits associated with this study. Patient able to give informed consent and would likely to comply with the study parameters.