MFOLFIRINOX And Stereotactic Radiotherapy (SBRT) for Pancreatic Cancer With High Risk and Locally Advanced Disease

Inclusion Criteria:

• Adults, aged between 18-75 years, with histological confirmation of pancreaticadenocarcinoma
• Any of the following

1. T3 (tumour >4 cm)
2. Extrapancreatic extension
3. Node positive (stage IIB)
4. Borderline resectable pancreatic cancer, locally advanced pancreatic cancer

• Measurable disease according to RECIST v1.1
• ECOG performance status 0-1
• Adequate renal and haematological function
• Adequate hepatic function. Defined as bilirubin <1.5 X ULN (Upper Limit of Normal),AST + ALT <3.0 X ULN. In patients who have had a recent biliary drainage and whosebilirubin is descending, a value of ≤ 3 X N is acceptable
• Study treatment planned to start within 14 days of registration
• Willing and able to comply with all study requirements, including treatment, timingand/or nature of required assessments
• Signed, written informed consent

Exclusion Criteria:

• Tumour size greater than 70mm
• Prior abdominal radiotherapy
• Evidence of metastatic disease on baseline radiologic investigations
• History of another malignancy within 2 years prior to randomisation, except adequatelytreated carcinoma-in-situ, basal cell carcinoma of the skin, squamous cell carcinomaof the skin, superficial transitional cell carcinoma of the bladder, or any Stage 1endometrial carcinoma. Patients with a history of other malignancies are eligible ifthey have been continuously disease free for at least 2 years after definitive primarytreatment
• Concurrent illness, including severe infection that may jeopardise the ability of thepatient to undergo the procedures outlined in this protocol with reasonable safety
• Neuroendocrine pancreatic carcinoma
• Life expectancy of less than 3 months
• Pregnancy, lactation, or inadequate contraception. Women must be post-menopausal,infertile, or use a reliable means of contraception. Women of childbearing potentialmust have a negative pregnancy test done within 7 days prior to registration. Men mustuse a reliable means of contraception
• Serious medical or psychiatric conditions that might limit the ability of the patientto comply with the protocol