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This therapeutic regimen combines the chemotherapy agent gemcitabine with intensity-modulated radiotherapy (IMRT), specifically investigated by the University of Michigan Rogel Cancer Center for the treatment of unresectable pancreatic adenocarcinoma. Gemcitabine is a nucleoside analog that inhibits DNA synthesis by targeting ribonucleotide reductase and competing with deoxycytidine triphosphate for incorporation into DNA by DNA polymerase. In this specific Phase I/II trial context, gemcitabine is administered at a fixed-dose rate (1000 mg/m²) concurrently with dose-escalated IMRT to improve local control and survival in patients with locally advanced, unresectable disease. The regimen leverages the radiosensitizing properties of gemcitabine to enhance the efficacy of targeted radiation delivery.
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