Intraoperative Radiation Therapy After Stereotactic Body Radiation Therapy and Chemotherapy in Treatment of Pancreatic Adenocarcinoma

This study is testing a combination of radiation therapy approaches — including targeted radiation during surgery — for people with pancreatic cancer that may be removable, borderline removable, or locally advanced. Researchers want to see if adding intraoperative radiation (radiation given directly during surgery) after standard pre-surgery treatment improves outcomes. **You may be eligible if...** - You are over 18 years old - You have pancreatic cancer (specifically in the head of the pancreas) confirmed by imaging - You are in reasonably good health (able to carry out daily activities) - You are being treated at Johns Hopkins and are a candidate for stereotactic body radiation therapy (SBRT) and possible surgery - You have started or plan to start multi-drug chemotherapy first **You may NOT be eligible if...** - You have had prior radiation to the chest or abdomen - Your tumor has spread beyond the pancreas - Your tumor is in the body or tail of the pancreas (not the head) - You cannot undergo the Whipple surgical procedure - You are pregnant or trying to become pregnant - You are already in another drug or device trial Talk to your doctor to see if this trial is right for you.