Intensity-Modulated Radiation Therapy and Gemcitabine in Treating Patients With Locally Advanced Pancreatic Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Pathologically confirmed adenocarcinoma or poorly differentiated carcinoma of the pancreas, ampulla of Vater, or distal bile duct
• * Locally advanced disease
• * Medically inoperable, unresectable, or borderline resectable disease
• * No previously resected disease (i.e., status post-pancreaticoduodenotomy)
• No non-adenocarcinoma, adenosquamous carcinoma, islet cell carcinoma, cyst adenoma, cystadenocarcinoma, carcinoid tumor, or duodenal carcinoma
• No lesions in the tail of the pancreas and/or splenic artery/vein involvement/encasement
• No recurrent or metastatic (M1) disease
• PATIENT CHARACTERISTICS:
• Karnofsky performance status 60-100%
• WBC \> 3,000/μL
• Platelet count \> 100,000/μL
• Bilirubin ≤ 2 mg/dL
• SGOT \< 5 times upper limit of normal (ULN)
• Creatinine \< 1.5 times ULN
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Adequate oral nutrition (e.g., ≥ 1,500 calories/day, stable weight for ≥ 2 weeks, and ≤ 5% weight loss)
• No active malignancy within the past 3 years, except cervical carcinoma in situ or nonmelanoma skin cancer that has been removed
• No severe, active comorbidity, including any of the following:
• * Unstable angina and/or congestive heart failure requiring hospitalization within the past 6 months
• * Transmural myocardial infarction within the past 6 months
• * Acute bacterial or fungal infection requiring IV antibiotics at the time of study registration
• * Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization within the past month or precluding study therapy at the time of study registration
• * Active hepatitis, decompensated cirrhosis, or clinically significant liver failure
• * Other severe comorbid condition, as determined by the principal investigator
• PRIOR CONCURRENT THERAPY:
• See Disease Characteristics
• No prior chemotherapy
• No prior radiotherapy to any upper abdominal site
• No concurrent prophylactic colony-stimulating factors during radiotherapy
• No concurrent warfarin
• No other concurrent chemotherapy, immunotherapy, hormonal cancer therapy, radiotherapy, surgery for cancer, or experimental therapy