The study aimed to generate a local failure (LF) risk map in resected pancreatic cancer (PC) and validate the results of previous studies, proposing new guidelines for PC postoperative radiotherapy clinical target volume (CTV) delineation. Follow-up computer tomography (CT) of resected PC was retrospectively reviewed by two radiologists identifying LFs and plotting them on a representative patient CT scan. The percentages of LF points randomly extracted based on CTV following the RTOG guidelines and based on the LF database were 70% and 30%, respectively. According to the Kernel density estimation, an LF 3D distribution map was generated and compared with the results of previous studies using a Dice index. Among the 64 resected patients, 59.4% underwent adjuvant treatment. LFs closer to the root of the celiac axis (CA) or the superior mesen-teric artery (SMA) were reported in 32.8% and 67.2% cases, respectively. The mean (± standard de-viation) distances of LF points to CA and SMA were 21.5 ± 17.9 mm and 21.6 ± 12.1 mm, respectively. The Dice values comparing our iso-level risk maps corresponding to 80% and 90% of the LF proba-bilistic density and the CTVs-80 and CTVs-90 of previous publications were 0.45–0.53 and 0.58–0.60, respectively. According to the Kernel density approach, a validated LF map was proposed, modeling a new adjuvant CTV based on a PC pattern of failure.

Definition of local recurrence site in resected pancreatic adenocarcinoma: A multicenter study (dolores-1)

Arcelli A.;Bertini F.;Guido A.;Cammelli S.;Buwenge M.;Bisello S.;Renzulli M.;Golfieri R.;Morganti A. G.;
2021

Abstract

The study aimed to generate a local failure (LF) risk map in resected pancreatic cancer (PC) and validate the results of previous studies, proposing new guidelines for PC postoperative radiotherapy clinical target volume (CTV) delineation. Follow-up computer tomography (CT) of resected PC was retrospectively reviewed by two radiologists identifying LFs and plotting them on a representative patient CT scan. The percentages of LF points randomly extracted based on CTV following the RTOG guidelines and based on the LF database were 70% and 30%, respectively. According to the Kernel density estimation, an LF 3D distribution map was generated and compared with the results of previous studies using a Dice index. Among the 64 resected patients, 59.4% underwent adjuvant treatment. LFs closer to the root of the celiac axis (CA) or the superior mesen-teric artery (SMA) were reported in 32.8% and 67.2% cases, respectively. The mean (± standard de-viation) distances of LF points to CA and SMA were 21.5 ± 17.9 mm and 21.6 ± 12.1 mm, respectively. The Dice values comparing our iso-level risk maps corresponding to 80% and 90% of the LF proba-bilistic density and the CTVs-80 and CTVs-90 of previous publications were 0.45–0.53 and 0.58–0.60, respectively. According to the Kernel density approach, a validated LF map was proposed, modeling a new adjuvant CTV based on a PC pattern of failure.
2021
Arcelli A.; Bertini F.; Strolin S.; Macchia G.; Deodato F.; Cilla S.; Parisi S.; Sainato A.; Fiore M.; Gabriele P.; Genovesi D.; Cellini F.; Guido A.; Cammelli S.; Buwenge M.; Loi E.; Bisello S.; Renzulli M.; Golfieri R.; Morganti A.G.; Strigari L.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/854100
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