BACKGROUND Only 10-20% of patients with pancreatic cancer are offered operation with curative intent. If this is not possible, treatment with pre-operative radiotherapy in combination with chemotherapy offers the opportunity to reduce tumor size in patients with locally advanced disease, and possibly resection with curative intent afterwards. This treatment has been offered for the last three years at the Department of Oncology, Odense University Hospital. In the following we present our results. METHODS A total of 26 patients with locally advanced unresectable pancreatic cancer were offered a combination of radiotherapy and chemotherapy. 4-6 weeks after treatment the patients were evaluated for resection. RESULTS Of the 26 patients 24 completed planned treatment. Eight patients were subsequently assessed resectable. One patient refused surgery; the other 7 patients had a R0-resection. Median survival for the whole group is 12 months. Six of the patients who went through surgery are without signs of recurrent disease after median 16 months, one patient died with recurrent disease after 37 months. CONCLUSIONS These results are similar to results from other countries. Therefore patients with locally advanced unresectable pancreatic cancer should be offered radiotherapy in combination with chemotherapy. Evaluation for surgery should be carried out 4-6 weeks after end of treatment. This strategy offers the opportunity for R0-recection and consequently cure.