Use of High-dose Radiation Therapy Plus Chemotherapy to Improve the Likelihood of Surgical Treatment in Patients With Locally Advanced Pancreatic Cancer

Inclusion Criteria

• •Histologically or cytopathologically confirmed adenocarcinoma of the pancreas.
• •Locally advanced, unresectable pancreatic cancer defined on post-induction chemotherapy CT as having tumor involvement of \>180° (\> 50%) of the circumference of the superior mesenteric artery (SMA) or celiac axis, unreconstructable superior mesenteric vein (SMV) or PV involvement.
• •No evidence of distant metastasis either prior to or after induction chemotherapy.
• •Completion of at least 3 months of standard induction chemotherapy for LAPC, which may include FOLFIRINOX or gemcitabine and nab-paclitaxel, within 6 weeks of enrollment.
• •For patients currently receiving investigational agents, a washout of at least 2 weeks or 5 half-lives of experimental agent are required prior to the start of RT.
• •Age ≥18 years.
• •KPS 70-100.
• •Patients must have acceptable organ and marrow function as defined below:
• •* Leukocytes \>3,000/µL
• •* Absolute neutrophil count \>1,500/µL
• •* Platelets \>75,000/µL
• •* Total bilirubin Within 2 x upper limit of normal
• •* AST (SGOT)/ALT (SGPT) \<2.5 x institutional upper limit of normal Creatinine Within 1.5 x upper limit of normal, OR Creatinine clearance \>60 mL/min for patients with creatinine levels above institutional normal
• •Any systemic therapy associated toxicity should be Grade 1 or less
• •Ability to understand and the willingness to sign a written informed consent document.