The Transformation of Locally Advanced Pancreatic Cancer.

Exclusion Criteria

• •1. Patients with pancreatic cancer who invaded adjacent organs or distant metastasis were found by imaging examination;
• •2. The patient has any active autoimmune disease or history of autoimmune disease (such as the following, but not limited to: autoimmune hepatitis, interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism; Patients with vitiligo; Asthma has been completely relieved in childhood and can be included without any intervention after adults; Asthma in which patients need bronchodilators for medical intervention cannot be included);
• •3. The patient is using immunosuppressant or systemic hormone therapy to achieve immunosuppression (dose \> 10mg/ day prednisone or other therapeutic hormones), and continues to use it within 2 weeks before entering the group;
• •4. It is known that there is a history of central nervous system metastasis or hepatic encephalopathy;
• •5. Suffering from hypertension, and can not be well controlled by antihypertensive drug treatment (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥ 90 mmHg);
• •6. There are clinical symptoms or diseases of the heart that are not well controlled, such as: (1) heart failure above 1)NYHA2 grade 2; (2) unstable angina pectoris; (3) myocardial infarction occurred within one year; (4) clinically significant supraventricular or ventricular arrhythmia needs treatment or intervention; (5)QTc\>450ms (male); QTc\>470ms (female);
• •7. Abnormal coagulation function (INR\>2.0, PT\>16s), bleeding tendency or receiving thrombolytic or anticoagulant therapy, allowing preventive use of low-dose aspirin and low-molecular-weight heparin;
• •8. In the first 3 months of randomization, there have been bleeding symptoms with significant clinical significance or clear bleeding tendency, such as daily cough/hemoptysis of 2.5ml or more, gastrointestinal bleeding, esophageal varices with bleeding risk, hemorrhagic gastric ulcer or vasculitis, etc. If stool occult blood is positive in baseline period, it can be re-examined. If it is still positive after re-examination, gastroscopy is needed. If gastroscopy indicates severe esophageal varices, it cannot be enrolled in the group (3 months before enrollment.
• •9. Arterial/venous thrombosis events occurring within the first 6 months, such as cerebrovascular accidents (including temporary ischemic attack, cerebral hemorrhage, cerebral infarction), deep venous thrombosis and pulmonary embolism, etc.;
• •10. Known hereditary or acquired bleeding and thrombotic tendencies (such as blood friend patients, coagulation dysfunction, thrombocytopenia, etc.);
• •11. Urine routine prompts urine protein ≥++and it is confirmed that the amount of urine protein in 24 hours is \> 1.0 g;
• •12. patients with active infection, fever of unknown origin ≥38.5℃ within 7 days before medication, or white blood cell count \> 15× 109/l at baseline; 13 patients with congenital or acquired immunodeficiency (such as HIV infection);
• •14.HBV DNA\>2000 IU/ml (or 104 copies/ml); Or HCV RNA\>103 copies/ml; Or HBsAg+ and anti-HCV antibody positive patients; 15. The patient has suffered from other malignant tumors in the past 3 years or at the same time (except the cured skin basal cell carcinoma and cervical carcinoma in situ); 16. Vaccination of live vaccine within less than 4 weeks before the study medication or during the study period; 17. There are peripheral neuropathy of grade \> 1; 18. Can not cooperate with positioning, positioning, treatment and respiratory motion control; 19. Suffering from uncontrollable mental illness; 20. It is known that there is a history of psychotropic drug abuse or drug abuse; According to the researcher's judgment, the patient has other factors that may affect the research results or lead to the forced termination of the research, such as alcoholism, drug abuse, other serious diseases (including mental diseases) that need to be treated together, serious laboratory examination abnormalities, family or social factors, etc., which will affect the safety of the patient.