Tumours of pancreas make up about 3 % of all malignant tumours excluding carcinoma of the skin. Overall 5 year survival is between 2–5 % regardless of the stage. Therfore, pancreatic cancer represents a serious therapeutic problem. Because of rich lymphatic drainage and early hepatic metastases only 10 % of pancreatic tumours are resectable. New therapeutic procedures are being developed with the main aim to improve survival and quality of life. A number of studies described diverse approaches including concomitant chemora- diotherapy, different cytostatics, intraoperative or preoperative radiotherapy. Methods: Our retrospective study evaluated 23 patients with primarily unresectable pancreatic carcinoma. These patients were treated by concomitant chemoradiotherapy: radiotherapy – dose of 40 Gy (2 Gy/fr.) in 2 cycles with a 14 day rest between cycles; chemotherapy – infusion of 5-fluorouracil, initial 3 days of both cycles in a dose of 500 mg/m 2 /day. The therapy went ahead with 5-FU in dose 500-600 mg/m 2 /day (weekly) until progression of carcinoma. Results: Median survival was 7 months for the whole group. No statistically significant difference between the survival of men and women (8 m. versus 7 m.) was observed. We also recorded no significant difference in survival comparing tumour location (head, corpus or cauda of the pancreas, respectively). The time to disease progression reached an average of 5.3 months (median 4.5 m). In ten patients hepatic metastases were diagnosed (43 %). The time to metastases diagnosis was 6.4 months. 20 patients died because of local progre- ssion or hepatic metastases. Three patients are still alive. Conclusions: Therapy of locally advanced carcinoma of pancreas remains a serious problem. The concomitant chemoradiotherapy appears to be the optimal therapeutic approach at the time. However, its effect is limited and the 7 month overall survival observed in our study is still unsatisfactory. Thus, other therapeutic methods and their combinations remain the subject of future studies.

        Key words: chemoradiotherapy – concomitant – pancreas – radiotherapy – unresectable