A 63-year-old woman was pointed out pancreatic tumor by a follow up CT after operation for the corpus uteri cancer. She was diagnosed as having locally advanced pancreatic cancer which involved the superior mesenteric vein (SMV). She was treated with radiation (1.8 Gyx28 Fr) and the combination chemotherapy of S-1 plus gemcitabine (S-1: 80 mg/m2/dayx28 days, gemcitabine 200 mg/m2/dayx6 fr, 1 fr a week). Indeed, grade 3 leukopenia and neutropenia were occurred by this treatment, she could be treated on schedule. Four weeks later from completion date, a reduction of the tumor size and an improvement of involving SMV were observed by diagnostic imaging. Subsequently, pylorus-preserving pancreatoduodenectomy (PpPD) with a partial resection of SMV and intraoperative radiation were undergone. She was discharged 19 days after the operation without any surgical complications, and is undergoing adjuvant chemotherapy.