Liposomal Irinotecan in Combination With Oxaliplatin and S-1 Versus Gemcitabine Combined With Capecitabine as Postoperative Adjuvant Therapy for Pancreatic Cancer

Inclusion Criteria: 1. Patients able and willing to provide a written informed consent aged 18-75 years. 2. Histologically confirmed resected ductal pancreatic adenocarcinoma (including adenosquamous carcinoma). 3. Undergone radical resection and confirmed macroscopic complete resection (R0 and R1). 4. Full recovery after surgery; able to start adjuvant treatment within 12 weeks after surgery. 5. Eastern Cooperative Oncology Group (ECOG) performance status 0-1. 6. The main organs function well. Exclusion Criteria: 1. Patients with other types of non-ductal tumor of the pancreas, including endocrine tumors or acinar cell adenocarcinoma, pancreatoblastoma, and solid-pseudopapillary tumor. 2. Macroscopic incomplete tumor removal (R2 resection). 3. Prior neo-adjuvant treatment, radiation therapy, or systemic therapy for pancreatic adenocarcinoma. 4. Presence or history of metastatic or locally recurrent pancreatic adenocarcinoma. 5. CA 19-9\> 180 U / ml within 21 days before randomization. 6. The toxicity of previous therapy has not recovered to Grade 1 or below. 7. Known peripheral neuropathy (CTCAE ≥ Grade 2). 8. Known deficiency of dihydropyrimidine dehydrogenase (DPD) 9. Subjects with a confirmed diagnosis of Gilbert's syndrome