Stereotactic Radiotherapy in Locally Advanced Pancreatic Cancer With Different Biological Effective Doses

Inclusion Criteria:

• Cytologically or histologically verified pancreatic adenocarcinoma

• Imaging examinations confirmed locally advanced pancreatic cancer

• No previous radiotherapy, chemotherapy, immunotherapy or targeted therapy

• ECOG of 0 to1

• Age of 18 years or older

• Adequate bone marrow function, defined as: Absolute neutrophil count (ANC) ≥ 1.5×10^9 cells/L, leukocyte count≥ 3.5×10^9 cells/L, platelets ≥ 70×10^9 cells/L,hemoglobin ≥ 8.0 g/dl

• Adequate liver and renal, defined as: Albumin > 2.5 g/dL, total bilirubin < 3 mg/dL,creatinine < 2.0 mg/dL, AST<2.5 × ULN (Upper Limit of Normal) (0-64U/L), ALT<2.5 ×ULN (0-64U/L)

• Adequate blood clotting function, defined as: international normalized ratio (INR) < 2 (0.9-1.1)

• Ability of the research subject or authorized legal representative to understand andthe willingness to sign a written informed consent document

Exclusion Criteria:

• Previously receiving radiotherapy, immunotherapy or targeted therapy

• Evidences of metastatic disease confirmed by chest CT or PET-CT

• ECOG ≥2

• Age <18 years

• Secondary malignancy

• Abnormal results of blood routine examinations and liver and kidney and coagulationtests

• Patients with active inflammatory bowel diseases or peptic ulcer

• Gastrointestinal bleeding or perforation within 6 months

• Uncontrolled infection requiring IV antibiotics, antivirals, or antifungals

• Medical history of symptomatic congestive heart failure: New York Heart AssociationClass III to IV

• Medical history of respiratory insufficiency

• Women who are pregnant or breastfeeding

• Participation in another clinical treatment trial

• Inability of the research subject or authorized legal representative to understandand the willingness to sign a written informed consent document