Prevention of Upper Gastrointestinal Hemorrhage Using Albis® in the Patients of Locally Advanced Pancreatic Cancer Who Underwent Concurrent Chemoradiotherapy
Prevention of Upper Gastrointestinal Hemorrhage Using Albis® in the Patients of Locally Advanced Pancreatic Cancer Who Underwent Concurrent Chemoradiotherapy
Pancreatic ductal adenocarcinoma is the fourth cause of death in the Western world. About 40%
 of pancreatic cancer patients were diagnosed as locally advanced unresectable status without
 distant metastasis. Concurrent chemoradiotherapy (CCRT) was a reasonable treatment modality
 for locally advanced pancreatic cancer. However, several adverse events of chemoradiation
 could lead unfavorable treatment results, which included unique gastrointestinal (GI)
 toxicities, such as ulcer and hemorrhage in the stomach and duodenum that are included in the
 radiation field. According to the study in the investigators hospital, 45% of locally
 advanced pancreatic cancer patients treated with CCRT suffered from GI ulcers, and among
 them, 65% of the patients experienced the significant hemorrhage events. Although these GI
 toxicities, the studies for radioprotective agents were limited. Albis® is a newly developed
 drug comprised of ranitidine, bismuth and sucralfate. The investigators will investigate the
 radioprotective effect of Albis® for locally advanced pancreatic cancer patients treated with
 CCRT.
Inclusion Criteria:

 -  Older than 20 years old and younger than 80 years old

 -  Pathologically confirmed pancreatic ductal adenocarcinoma (metastatic or locally
 advanced stage)

 -  ECOG Performance status ≤2

 -  Scheduled fot concurrent chemoradiation

 -  Adequate liver function (total bilirubin < 1.5 X the upper limits of normal (ULN), AST
 and ALT <3 X UNL, and alkaline phosphatases < 3 X ULN or < 5 x ULN in case of liver
 involvement)

 -  Adequate BM function (WBC ≥ 3,500/µl, absolute neutrophil cell count ≥ 1,500 /µl,
 platelet count ≥ 100,000/µl)

 -  Not remarkable coagulation profile (PT < 1.5 international normalized ratio(INR), aPTT
 <35 sec)

 -  Subjects who given written informed consent after being given a full description of
 the study

 Exclusion Criteria:

 -  Coexisting of other malignancies within 5 years, except squamous cell carcinoma and
 basal cell carcinoma of the skin

 -  Evidence of distant metastasis, such as liver, peritoneum and brain

 -  history of receiving the chemoradiation for pancreatic cancer in the other hospital

 -  History of receiving the operation which affect the anatomy of upper gastrointestinal
 tract

 -  Any trouble for examination of upper endoscopy

 -  Evidence of GI ulcers (A1~H2) on endoscopy before start of chemoradiotherapy.

 -  Use of aspirin, anti-platelet agent, anticoagulation agent, NSAIDs, or glucocorticoid
 within 1 week or enable to stop the administration (including start during
 chemoradiation)

 -  Use of PPI, Histamine-2 receptor antagonist, antacid, prostaglandin, sucralfate within
 2 weeks or enable to stop the administration

 -  Patients who are unwilling or unable to provide informed consent, such as those with
 psychiatric problem, drug abuse or alcoholism