Simultaneous Gemcitabine and Irreversible Electroporation for Locally Advanced Pancreatic Cancer

Inclusion Criteria:

* Radiologic confirmation of unresectable locally advanced pancreatic cancer by at least CT of chest and abdomen
* Screening must be performed no longer than 2 weeks prior to study inclusion
* Maximum tumor diameter ≤ 5 cm
* Histological or cytological confirmation of pancreatic adenocarcinoma;
* Age ≥ 18 years
* PS-classification 0 - 2
* Life expectancy of at least 12 weeks
* Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to definite inclusion;
* Hemoglobin level ≥ 115 g/L
* Platelet count ≥ 100\*109/l
* Neutrophil count ≥ 2×109/L;
* White blood cell count ≥ 4 ×109/L;
* ALT and AST ≤ 2.5 x ULN
* Serum creatinine ≤ 1.5 x ULN or a calculated creatinine clearance ≥ 50 ml/min
* Prothrombin time or INR \< 1.5 x ULN
* Written informed consent

Exclusion Criteria:

* Resectable pancreatic adenocarcinoma as discussed by our multidisciplinary hepatobiliary team
* History of epilepsy
* History of cardiac disease:
* Cardiac arrhythmias requiring anti-arrhythmic therapy or pacemaker (beta blockers for antihypertensive regimen are permitted)
* Compromised liver function (e.g. signs of portal hypertension, INR \> 1,5 without use of anticoagulants, ascites)
* Uncontrolled infections (\> grade 2 NCI-CTC version 3.0)
* Pregnant. Women of childbearing potential must have a negative pregnancy test performed within 7 days of the start of treatment
* Allergy to contrast media
* Any implanted stimulation device
* Any implanted metal stent/device within the area of ablation that cannot be removed