A Study of Pre-Operative Cyberknife in Patients With Potentially Resectable Pancreas Cancer

Inclusion Criteria:

* Pathologically confirmed adenocarcinoma of the pancreas
* Resectable or potentially resectable disease based on the following imaging criteria performed \< 4 weeks from study entry and as determined by local review (Cooper radiologist)

  * No extrapancreatic extension to nearby organs (ie; small bowel)
  * No SMV/PV \>180 degree involvement and/or reconstructable (as determined by Surgeon) occlusion
  * No SMA Abutment TVI\<180 degrees
  * No Celiac trunk abutment Total volume involved \< 180 degrees
  * Note that both resectable and potentially resectable patients are eligible
* ECOG ≤ 2
* Adequate hematologic and end organ function as defined by

  * Hepatic transaminase levels \< 3 x normal
  * Total bilirubin \< 5 mg/dl (if stented)
  * Serum creatinine level \< 1.6 mg/dl
  * Absolute neutrophil count \> 1,500cells/mm3
  * Platelet count \> 100,000 cells/mm3
* Medical status suitable for consideration of major pancreatic surgery
* Age \>18 years
* Women of childbearing age and male participants must practice adequate contraception (hormonal or barrier method of birth control; abstinence) prior to and throughout study treatment.
* Life expectancy \> 3 months
* Ability to understand and the willingness to sign a written informed consent.

Exclusion Criteria:

* Prior invasive malignancy within 5 years other than pancreatic adenocarcinoma
* Prior radiotherapy to the upper abdomen
* Severe comorbidity rendering a candidate ineligible for surgical resection
* Local, regional or distant extrapancreatic disease
* Patients of childbearing age who are unwilling or unable to practice contraception
* Failure to meet any of the above eligibility criteria
* Inability to undergo MRI with contrast for treatment planning
* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
* Patients may not be receiving any other investigational nor commercial agents with therapeutic intent to treat pancreatic cancer while on this trial.
* unresectable pancreatic cancer based on the following imaging criteria performed \< 4 weeks from study entry and as determined by local review (Cooper radiologist)

  * Extrapancreatic extension to nearby organs (ie; small bowel)
  * SMV/PV \>180 degree involvement and/or reconstructable (as determined by Surgeon) occlusion
  * SMA Abutment TVI\<180 degrees
  * Celiac trunk abutment Total volume involved \< 180 degrees
  * Distant metastases