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.
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., Definition of local recurrence site in resected pancreatic adenocarcinoma: A multicenter study (dolores-1), <<CANCERS>>, 2021; 13 (12): N/A-N/A. [doi:10.3390/cancers13123051] [http://hdl.handle.net/10807/203387]
Definition of local recurrence site in resected pancreatic adenocarcinoma: A multicenter study (dolores-1)
Macchia, Gabriella;Deodato, Francesco;Cilla, Savino;Cellini, Francesco;Morganti, Alessio Giuseppe;
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.
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