Data from other trials failed to demonstrate meaningful survival advantage

The purpose is to assess the overall survival of patients receiving either UFT/LV + radiotherapy (RT) or UFT/LV + Cetuximab + RT after neo-adjuvant chemotherapy.

Locally advanced pancreatic cancer carries a poor prognosis with no survival advantage of CRT over chemotherapy alone. 4 Phase II- III studies patients without disease progression after 3 months of systemic chemotherapy and CRT had a longer survival than those continuing on chemotherapy. Therefore chemotherapy followed by CRT may be a better approach. Also the effect of blocking EGFR will be evaluated in locally advanced pancreatic cancer. Gemcitabine and capecitabine combination will be used as neo-adjuvant chemotherapy.

Inclusion Criteria:

• Age >18
• Histological or cytological diagnosis of adeno- or undifferentiated non-small cell carcinoma of pancreas.
• Considered to be unresectable based on following: extensive peri-pancreatic lymph node involvement, encasement or occlusion of the SMV or SMV/portal vein confluence, direct involvement of SMA, coeliac axis, inferior vena cava or aorta.
• Performance status 0-2
• No evidence of metastatic disease as determined by CT scan/ other investigations
• Adequate bone marrow function with platelets>100^9/l; WBC>3x10^9/l;neutrophils> 1.5x10^9/l
• Serum bilirubin ,1.5 x ULN and transaminases < 2.5 x ULN
• Calculated/measured GFR >50ml/min
• No concurrent uncontrolled medical condition
• No active malignant disease other than non-melanotic skin cancer or carcinoma in situ of the uterine cervix over the last 10 years
• Life expectancy > 3months
• Adequate contraceptive precautions
• Informed written consent

Exclusion Criteria:

• medical or psychiatric conditions that compromise the patient's ability to give informed consent
• Presence of met. disease
• Concurrent uncontrolled medical conditions
• Any previous chemo/RT or any investigational treatment for advanced pancreatic cancer.
• Adjuvant chemo + fluoropyrimidine or gemcitabine within 12months of trial entry
• Adjuvant RT with/without chemo for pancreatic cancer.
• Pregnancy/breast feeding
• Patients with known malabsorption syndromes ro a lack of physical treatment of the upper GI tract.
• Patients with a known hypersensitivity to 5-FU or with a DPD deficiency.
• Clinically significant CVD