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 pancreatic adenocarcinoma * 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 whose bilirubin 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, timing and/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 adequately treated carcinoma-in-situ, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial transitional cell carcinoma of the bladder, or any Stage 1 endometrial carcinoma. Patients with a history of other malignancies are eligible if they have been continuously disease free for at least 2 years after definitive primary treatment * Concurrent illness, including severe infection that may jeopardise the ability of the patient 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 potential must have a negative pregnancy test done within 7 days prior to registration. Men must use a reliable means of contraception * Serious medical or psychiatric conditions that might limit the ability of the patient to comply with the protocol