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Abstract This prospective study was conducted at clinical oncology department. Tanta University Hospitals and Gharbia Cancer center. It included 40 patients with locally advanced unresectable pancreatic cancer throughout the period from March 2018 to December 2020.The aim of this study was evaluation of the treatment response and toxicity in patients with locally advanced unresectable pancreatic cancer patients receiving induction chemotherapy followed by concomittant chemoradiation therapy by IMRT technique. And whether this technique can achieve high R0 resection or not. We found the following results: Age ranged between 40-65 years with a median age of 48 years. Males were more common than females. Males represented 60% (24/40), while females represented 40% (16/20) with male to female ratio 1.5. The performance status of the patients in this study was scored according to ECOG. 72% of patients (29/40) had a good performance status 0-1, while eleven (27.5%) patients had performance status 2. Twenty one patients (52.5%) were presented by obstructive jaundice and ninteen of them (47.5%) needed a pre-treatment stenting to relieve obstruction. Head of pancreas was the most common site of pancreatic adenocarcinoma and accounted for 57.5% (23/40) of patients. Most of patients [(23/40), 57.5%] were presented by T3 tumor, while sixteen patients [(16/40),40%] presented with T4 tumor. Only one patients had a T2 tumor. Twenty three patients (57.5%) had lymph node involvement. The tumor marker (CA19.9) was sensitive and elevated in 35 patients (87.5%) while it was not elevated in 5 patients. Gemcitabine and oxaloplatin was the most common regimen received by fifteen patients and accounted for 37.5%, Gemcitabine and platinol was |