Gemcitabine and Radiation Therapy in Treating Patients With Locally Advanced Upper Gastrointestinal Cancer
Extrahepatic Bile Duct Cancer, Gallbladder Cancer, Gastric Cancer
About this trial
This is an interventional treatment trial for Extrahepatic Bile Duct Cancer focused on measuring adenocarcinoma of the extrahepatic bile duct, adenocarcinoma of the gallbladder, adenocarcinoma of the pancreas, adenocarcinoma of the stomach, stage I pancreatic cancer, stage II pancreatic cancer, stage III pancreatic cancer, localized extrahepatic bile duct cancer, recurrent extrahepatic bile duct cancer, unresectable extrahepatic bile duct cancer, localized gallbladder cancer, recurrent gallbladder cancer, unresectable gallbladder cancer, recurrent gastric cancer, stage II gastric cancer, stage III gastric cancer, stage IV gastric cancer, stage I gastric cancer, recurrent pancreatic cancer, small intestine adenocarcinoma, stage IV pancreatic cancer
Eligibility Criteria
DISEASE CHARACTERISTICS:
Diagnosis of any of the following upper gastrointestinal malignancies:
Localized pancreatic adenocarcinoma
- Stage I, II, or III disease
- Parapancreatic node involvement and locally recurrent disease allowed
Locally advanced biliary, gallbladder, or ampullary adenocarcinoma
- Stage II, III, or locally recurrent disease
Histologically confirmed locally advanced gastric adenocarcinoma
- T3, T4, or node positive OR locally recurrent disease
Histologically confirmed locally advanced duodenal cancer
- Stage II or III disease
- Locally advanced, but unresectable cancers may be included on protocol if appropriate for intraoperative radiotherapy (IORT)
- Other histologies may be considered for this protocol except for lymphoma, sarcoma, or neuroendocrine tumors
- Patients with evidence of metastatic disease are eligible if there is significant local disease warranting surgery and IORT
PATIENT CHARACTERISTICS:
- Karnofsky performance status > 60%
- Life expectancy > 4 months
- Absolute neutrophil count > 1,500/mm^3
- Platelet count > 100,000/mm^3
- Serum creatinine < 2.0 mg/dL
- ALT < 3 x normal
- Bilirubin < 2 x normal
- Must be able to give voluntary informed consent
- No severe intercurrent illness that would make the patient inappropriate for laparotomy or otherwise inappropriate for treatment on protocol
- Prior history of malignancy allowed
PRIOR CONCURRENT THERAPY:
- More than 4 weeks since prior chemotherapy (6 weeks for mitomycin C)
- Prior gemcitabine hydrochloride allowed