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2. May we routinely spare hippocampal region in primary central nervous system lymphoma during whole brain radiotherapy?

Author

Mazzarella, Ciro, Chiesa, Silvia, Toppi, Lucrezia, Hohaus, Stefan, Gaudino, Simona, D’Alo, Francesco, Dinapoli, Nicola, Davide, Resta, Zinicola, Tiziano, Bracci, Serena, Martino, Antonella, Beghella Bartoli, Francesco, Lepre, Elisabetta, Bertolini, Roberta, Mariani, Silvia, Colosimo, Cesare, Frascino, Vincenzo, Mattiucci, Gian Carlo, Gambacorta, Maria Antonietta, Valentini, Vincenzo, and Balducci, Mario

Published
2023
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3. Magnetic resonance guided SBRT reirradiation in locally recurrent prostate cancer: a multicentric retrospective analysis

Author

Boldrini, Luca, Romano, Angela, Chiloiro, Giuditta, Corradini, Stefanie, De Luca, Viola, Verusio, Valeria, D’Aviero, Andrea, Castelluccia, Alessandra, Alitto, Anna Rita, Catucci, Francesco, Grimaldi, Gianmarco, Trapp, Christian, Hörner-Rieber, Juliane, Marchesano, Domenico, Frascino, Vincenzo, Mattiucci, Gian Carlo, Valentini, Vincenzo, Gentile, Piercarlo, and Gambacorta, Maria Antonietta

Published
2023
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5. Interventional radiotherapy (brachytherapy) for re-irradiation of recurrent head and neck malignancies: oncologic outcomes and morbidity

Author

Bussu, Francesco, primary, Fionda, Bruno, additional, Rigante, Mario, additional, Rizzo, Davide, additional, Loperfido, Antonella, additional, Gallus, Roberto, additional, De Luca, Laura Maria, additional, Corbisiero, Michaele Francesco, additional, Lancellotta, Valentina, additional, Tondo, Andrea, additional, D’Aviero, Andrea, additional, Mattiucci, Gian Carlo, additional, Kovacs, Gyorgy, additional, Galli, Jacopo, additional, and Tagliaferri, Luca, additional

Published
2024
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6. Artificial Intelligence in magnetic Resonance guided Radiotherapy: Medical and physical considerations on state of art and future perspectives

Author

Cusumano, Davide, Boldrini, Luca, Dhont, Jennifer, Fiorino, Claudio, Green, Olga, Güngör, Görkem, Jornet, Núria, Klüter, Sebastian, Landry, Guillaume, Mattiucci, Gian Carlo, Placidi, Lorenzo, Reynaert, Nick, Ruggieri, Ruggero, Tanadini-Lang, Stephanie, Thorwarth, Daniela, Yadav, Poonam, Yang, Yingli, Valentini, Vincenzo, Verellen, Dirk, and Indovina, Luca

Published
2021
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9. From applicator-based (Paris system) implantations to rhinoseptoplasty: the concept of anatomic implantation for interventional radiotherapy in squamous cell carcinoma of the nasal vestibule. Short term results in a monoinstitutional series

Author

MS Radiotherapie, Cancer, MS Hoofd-Hals Chirurgische Oncologie, MS KNO, Tropiano, Paolo, Tagliaferri, Luca, Tondo, Andrea, Varrucciu, Simona, Gallus, Roberto, Mattiucci, Gian Carlo, Ridder, Mischa De, Rijken, Johannes A., Scheurleer, W. F. Julius, D’Aviero, Andrea, Fionda, Bruno, Riu, Francesco Giuseppe, Bussu, Francesco, MS Radiotherapie, Cancer, MS Hoofd-Hals Chirurgische Oncologie, MS KNO, Tropiano, Paolo, Tagliaferri, Luca, Tondo, Andrea, Varrucciu, Simona, Gallus, Roberto, Mattiucci, Gian Carlo, Ridder, Mischa De, Rijken, Johannes A., Scheurleer, W. F. Julius, D’Aviero, Andrea, Fionda, Bruno, Riu, Francesco Giuseppe, and Bussu, Francesco

Published
2024

11. A Deep Learning Approach for the Fast Generation of Synthetic Computed Tomography from Low-Dose Cone Beam Computed Tomography Images on a Linear Accelerator Equipped with Artificial Intelligence.

Author

Vellini, Luca, Zucca, Sergio, Lenkowicz, Jacopo, Menna, Sebastiano, Catucci, Francesco, Quaranta, Flaviovincenzo, Pilloni, Elisa, D'Aviero, Andrea, Aquilano, Michele, Di Dio, Carmela, Iezzi, Martina, Re, Alessia, Preziosi, Francesco, Piras, Antonio, Boschetti, Althea, Piccari, Danila, Mattiucci, Gian Carlo, and Cusumano, Davide

Subjects
CONE beam computed tomography, DEEP learning, COMPUTED tomography, ARTIFICIAL intelligence, LINEAR accelerators, GENERATIVE adversarial networks
Abstract

Featured Application: The neural network proposed allows for the removal of the CT simulation from the clinical workflow, paving the way for fast-track radiotherapy. Artificial Intelligence (AI) is revolutionising many aspects of radiotherapy (RT), opening scenarios that were unimaginable just a few years ago. The aim of this study is to propose a Deep Leaning (DL) approach able to quickly generate synthetic Computed Tomography (CT) images from low-dose Cone Beam CT (CBCT) acquired on a modern linear accelerator integrating AI. Methods: A total of 53 patients treated in the pelvic region were enrolled and split into training (30), validation (9), and testing (14). A Generative Adversarial Network (GAN) was trained for 200 epochs. The image accuracy was evaluated by calculating the mean and mean absolute error (ME and ME) between sCT and CT. RT treatment plans were calculated on CT and sCT images, and dose accuracy was evaluated considering Dose Volume Histogram (DVH) and gamma analysis. Results: A total of 4507 images were selected for training. The MAE and ME values in the test set were 36 ± 6 HU and 7 ± 6 HU, respectively. Mean gamma passing rates for 1%/1 mm, 2%/2 mm, and 3%/3 mm tolerance criteria were respectively 93.5 ± 3.4%, 98.0 ± 1.3%, and 99.2 ± 0.7%, with no difference between curative and palliative cases. All the DVH parameters analysed were within 1 Gy of the difference between sCT and CT. Conclusion: This study demonstrated that sCT generation using the DL approach is feasible on low-dose CBCT images. The proposed approach can represent a valid tool to speed up the online adaptive procedure and remove CT simulation from the RT workflow. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Validation of the “Rome” Classification for Squamous Cell Carcinoma of the Nasal Vestibule

Author

Scheurleer, Willem Frederik Julius, primary, de Ridder, Mischa, additional, Tagliaferri, Luca, additional, Crescio, Claudia, additional, Parrilla, Claudio, additional, Mattiucci, Gian Carlo, additional, Fionda, Bruno, additional, Deganello, Alberto, additional, Galli, Jacopo, additional, de Bree, Remco, additional, Rijken, Johannes A., additional, and Bussu, Francesco, additional

Published
2023
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14. Magnetic Resonance, Vendor-independent, Intensity Histogram Analysis Predicting Pathologic Complete Response After Radiochemotherapy of Rectal Cancer

Author

Dinapoli, Nicola, Barbaro, Brunella, Gatta, Roberto, Chiloiro, Giuditta, Casà, Calogero, Masciocchi, Carlotta, Damiani, Andrea, Boldrini, Luca, Gambacorta, Maria Antonietta, Dezio, Michele, Mattiucci, Gian Carlo, Balducci, Mario, van Soest, Johan, Dekker, Andre, Lambin, Philippe, Fiorino, Claudio, Sini, Carla, De Cobelli, Francesco, Di Muzio, Nadia, Gumina, Calogero, Passoni, Paolo, Manfredi, Riccardo, and Valentini, Vincenzo

Published
2018
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16. 1357: Secondary analysis of a multicenter observational study in pancreatic cancer.

Author

Arcelli, Alessandra, Tarantino, Giuseppe, Cellini, Francesco, Buwenge, Milly, Macchia, Gabriella, Bertini, Federica, Guido, Alessandra, Deodato, Francesco, Cilla, Savino, Scotti, Valerio, Rosetto, Maria Elena, Djan, Igor, Parisi, Salvatore, Mattiucci, Gian Carlo, Fiore, Michele, Bonomo, Pierluigi, Belgioia, Liliana, Niespolo, Rita Marina, Gabriele, Pietro, Di Marco, Mariacristina, Simoni, Nicola, Ma, Johnny, Strigari, Lidia, Mazzarotto, Renzo, and Morganti, Alessio Giuseppe

Published
2024
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18. Validation of the "Rome" Classification for Squamous Cell Carcinoma of the Nasal Vestibule.

Author

Scheurleer, Willem Frederik Julius, de Ridder, Mischa, Tagliaferri, Luca, Crescio, Claudia, Parrilla, Claudio, Mattiucci, Gian Carlo, Fionda, Bruno, Deganello, Alberto, Galli, Jacopo, de Bree, Remco, Rijken, Johannes A., and Bussu, Francesco

Subjects
HEAD & neck cancer diagnosis, STATISTICS, RESEARCH methodology, MULTIVARIATE analysis, HEAD & neck cancer, NASAL cavity, TUMOR classification, COMPARATIVE studies, CANCER patients, DESCRIPTIVE statistics, NASAL tumors, SENSITIVITY & specificity (Statistics), PROGRESSION-free survival, SQUAMOUS cell carcinoma, OVERALL survival
Abstract

Simple Summary: Nasal vestibule cancer is considered to be a rare form of cancer. There are several different staging systems in place for categorizing these tumors, which can result in inconsistencies and unreliable data due to variations in registration. The "Rome" classification is the most recent addition. This study aimed to assess the effectiveness of this new staging system and to compare it to the UICC/AJCC system. One hundred and forty-nine patients with a squamous cell carcinoma of the nasal vestibule were included. There was a significant association between an increased disease stage as staged per the Rome classification and decreased survival. This association persisted when correcting for various covariates (i.e., age at the time of diagnosis, sex, the presence of lymph node metastases, and treatment modality) in multivariable analysis. The Rome classification appears to be capable of adequately categorizing and stratifying patients for different outcome measures. Nevertheless, additional research with a larger number of patients is required before any definitive conclusions can be drawn. Squamous cell carcinoma of the nasal vestibule is considered a rare malignancy that differs from other sinonasal malignancies in many respects. Four staging systems currently exist for this disease, the most recent addition being the "Rome" classification. This study assesses the use of this new classification and its prognostic value regarding various outcome measures. A retrospective multicenter cohort study of patients with a primary squamous cell carcinoma of the nasal vestibule who were treated in three tertiary head and neck oncology referral centers was conducted. A total of 149 patients were included. The median follow-up duration was 27 months. Five-year locoregional control (LRC), disease-specific survival (DSS), and overall survival (OS) were 81.6%, 90.1, and 62.5% respectively. A statistically significant association was observed between the Rome classification and all survival outcomes in both univariable and multivariable analyses. Moreover, it appeared to perform better than the Union for International Cancer Control TNM classification for tumors of the nasal cavity and paranasal sinuses. The new Rome classification can be used effectively and is associated with LRC, DSS, and OS. However, it requires further validation in a larger (prospective) study population. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Role of Chemoradiation in the Adjuvant Treatment of Radically Resected Pancreatic Cancer Patients: A Mono-Institutional Retrospective Analysis

Author

Mattiucci, Gian Carlo, Salvatore, Lisa, D'Aviero, Andrea, Bagalà, Cinzia, Bensi, Maria, Castronovo, Francesco Mosè, Cellini, Francesco, De Franco, Paola, Di Stefano, Brunella, Macchia, Gabriella, Masiello, Valeria, Menghi, Roberta, Quero, Giuseppe, Reina, Sara, Morganti, Alessio Giuseppe, Alfieri, Sergio, Tortora, Giampaolo, Valentini, Vincenzo, Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Cellini, Francesco (ORCID:0000-0002-2145-2300), Quero, Giuseppe (ORCID:0000-0002-0001-9479), Alfieri, Sergio (ORCID:0000-0002-0404-724X), Tortora, Giampaolo (ORCID:0000-0002-1378-4962), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Mattiucci, Gian Carlo, Salvatore, Lisa, D'Aviero, Andrea, Bagalà, Cinzia, Bensi, Maria, Castronovo, Francesco Mosè, Cellini, Francesco, De Franco, Paola, Di Stefano, Brunella, Macchia, Gabriella, Masiello, Valeria, Menghi, Roberta, Quero, Giuseppe, Reina, Sara, Morganti, Alessio Giuseppe, Alfieri, Sergio, Tortora, Giampaolo, Valentini, Vincenzo, Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Cellini, Francesco (ORCID:0000-0002-2145-2300), Quero, Giuseppe (ORCID:0000-0002-0001-9479), Alfieri, Sergio (ORCID:0000-0002-0404-724X), Tortora, Giampaolo (ORCID:0000-0002-1378-4962), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)

Abstract

Introduction: Pancreatic cancer (PC) represents an unfavorable prognosis condition, even in patients with resectable disease. The aim of this series was to investigate the role of treatment intensification with adjuvant chemoradiation (CRT) in radically resected PC patients. Methods: Data from PC patients who underwent radical surgery, adjuvant chemotherapy (CT), and CRT throughout a 20-year period were retrospectively collected. Actuarial local control (LC) and the overall survival (OS) were the primary endpoints, with disease-free survival and metastasis-free survival (MFS) representing secondary endpoints. Results: The analysis included 108 PC patients treated with adjuvant CRT and CT from January 2000 to August 2019. Median age was 66 years (range: 40-83), and all patients underwent radical surgical resection with adjuvant CT (88, 81.5%) plus concomitant CRT (101, 93.5%) or radiotherapy alone (7, 6.5%). The median dose delivered to the tumor bed was 50.4 Gy (range: 45-50.6 Gy), while median dose to regional lymphatic drainage stations was 39.6 Gy (range 39.6-45 Gy). Concomitant CT was a gemcitabine-based regimen in the vast majority of patients (87, 80.6%). Median follow-up time was 21 months; the 2- and 5-year LC rates were 75.8% and 59.1%, respectively. Perineural invasion at pathological assessment was found significantly associated with LC (p = 0.028). Median OS was 40 months with 2- and 5-year OS rates of 73.9% and 41.6%, respectively. Conclusions: The outcomes of this series suggest to investigate the possible impact of adding adjuvant CRT to CT in PC patients. Timing and combination of modern CRT with new systemic therapies need to be further investigated to personalize therapy and optimize clinical advantages. (c) 2022 S. Karger AG, Basel

Published
2022

20. A deep learning approach to generate synthetic CT in low field MR-guided radiotherapy for lung cases

Author

Lenkowicz, Jacopo, Votta, Claudio, Nardini, Matteo, Quaranta, Flaviovincenzo, Catucci, Francesco, Boldrini, Luca, Vagni, Marica, Menna, Sebastiano, Placidi, Lorenzo, Romano, Angela, Chiloiro, Giuditta, Gambacorta, Maria Antonietta, Mattiucci, Gian Carlo, Indovina, Luca, Valentini, Vincenzo, Cusumano, Davide, Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Lenkowicz, Jacopo, Votta, Claudio, Nardini, Matteo, Quaranta, Flaviovincenzo, Catucci, Francesco, Boldrini, Luca, Vagni, Marica, Menna, Sebastiano, Placidi, Lorenzo, Romano, Angela, Chiloiro, Giuditta, Gambacorta, Maria Antonietta, Mattiucci, Gian Carlo, Indovina, Luca, Valentini, Vincenzo, Cusumano, Davide, Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)

Abstract

Introduction: This study aims to apply a conditional Generative Adversarial Network (cGAN) to generate synthetic Computed Tomography (sCT) from 0.35 Tesla Magnetic Resonance (MR) images of the thorax.Methods: Sixty patients treated for lung lesions were enrolled and divided into training (32), validation (8), internal (10,TA) and external (10,TB) test set. Image accuracy of generated sCT was evaluated comput-ing the mean absolute (MAE) and mean error (ME) with respect the original CT. Three treatment plans were calculated for each patient considering MRI as reference image: original CT, sCT (pure sCT) and sCT with GTV density override (hybrid sCT) were used as Electron Density (ED) map. Dose accuracy was evaluated comparing treatment plans in terms of gamma analysis and Dose Volume Histogram (DVH) parameters.Results: No significant difference was observed between the test sets for image and dose accuracy param-eters. Considering the whole test cohort, a MAE of 54.9 & PLUSMN; 10.5 HU and a ME of 4.4 & PLUSMN; 7.4 HU was obtained. Mean gamma passing rates for 2%/2mm, and 3%/3mm tolerance criteria were 95.5 & PLUSMN; 5.9% and 98.2 & PLUSMN; 4.1% for pure sCT, 96.1 & PLUSMN; 5.1% and 98.5 & PLUSMN; 3.9% for hybrid sCT: the difference between the two approaches was significant (p = 0.01). As regards DVH analysis, differences in target parameters estima-tion were found to be within 5% using hybrid approach and 20% using pure sCT.Conclusion: The DL algorithm here presented can generate sCT images in the thorax with good image and dose accuracy, especially when the hybrid approach is used. The algorithm does not suffer from inter -scanner variability, making feasible the implementation of MR-only workflows for palliative treatments.(c) 2022 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 176 (2022) 31-38

Published
2022

21. New standards for the management of nose vestibule malignancies

Author

Bussu, Francesco, Tagliaferri, Luca, Crescio, Claudia, Rizzo, Davide, Gallus, Roberto, Parrilla, Claudio, Fionda, Bruno, Lancellotta, Valentina, Mattiucci, Gian Carlo, Galli, Jacopo, Francesco Bussu (ORCID:0000-0001-6261-2772), Luca Tagliaferri, Claudio Parrilla, Bruno Fionda, Valentina Lancellotta, Gian Carlo Mattiucci (ORCID:0000-0001-6500-0413), Jacopo Galli (ORCID:0000-0001-6353-6249), Bussu, Francesco, Tagliaferri, Luca, Crescio, Claudia, Rizzo, Davide, Gallus, Roberto, Parrilla, Claudio, Fionda, Bruno, Lancellotta, Valentina, Mattiucci, Gian Carlo, Galli, Jacopo, Francesco Bussu (ORCID:0000-0001-6261-2772), Luca Tagliaferri, Claudio Parrilla, Bruno Fionda, Valentina Lancellotta, Gian Carlo Mattiucci (ORCID:0000-0001-6500-0413), and Jacopo Galli (ORCID:0000-0001-6353-6249)

Abstract

Background: Nasal vestibule squamous cell carcinoma (NVSCC) is an ill-defined underestimated condition. Aim/objective: To define the current standard of care. Material and methods: We review recent acquisitions concerning clinical features and therapeutic approaches. Results: The current AJCC staging system, which attributes to nasal vestibule the same topographic code as nasal cavity proper and the same T-classification criteria as ethmoid, appears inadequate.As for treatment of primary lesions without bone invasion, current evidence suggests that brachytherapy is at least equivalent to surgery and superior to external beams in terms of oncological outcomes, and superior to both modalities in terms of cosmesis and function. Conclusions: As for classification and staging, the nasal vestibule should be defined as a subsite of the nose and paranasal sinuses, distinct from the 'nasal cavity proper and ethmoid', with specific topographic code and T-classification criteria. This will improve the assessment of prognosis and prevalence, underestimated also because of misdiagnosis with skin cancers.Secondly, brachytherapy should become the new standard for the treatment of primary lesions without bone invasion. To optimize the advantages of brachytherapy, we propose novel anatomic criteria for the implantation. Significance: Increasing evidence supports a paradigm shift in staging and treatment of NVSCC.

Published
2023

22. Evaluation of Staging Systems for Cancer of the Nasal Vestibule

Author

MS Hoofd-Hals Chirurgische Oncologie, MS KNO, MS Radiologie, Cancer, MS Radiotherapie, Scheurleer, Willem Frederik Julius, Tagliaferri, Luca, Rijken, Johannes A, Crescio, Claudia, Rizzo, Davide, Mattiucci, Gian Carlo, Pameijer, Frank A, de Bree, Remco, Fionda, Bruno, de Ridder, Mischa, Bussu, Francesco, MS Hoofd-Hals Chirurgische Oncologie, MS KNO, MS Radiologie, Cancer, MS Radiotherapie, Scheurleer, Willem Frederik Julius, Tagliaferri, Luca, Rijken, Johannes A, Crescio, Claudia, Rizzo, Davide, Mattiucci, Gian Carlo, Pameijer, Frank A, de Bree, Remco, Fionda, Bruno, de Ridder, Mischa, and Bussu, Francesco

Published
2023

24. Adjuvant chemoradiation in pancreatic cancer: impact of radiotherapy dose on survival

Author

Morganti, Alessio G., Cellini, Francesco, Buwenge, Milly, Arcelli, Alessandra, Alfieri, Sergio, Calvo, Felipe A., Casadei, Riccardo, Cilla, Savino, Deodato, Francesco, Di Gioia, Giancarmine, Di Marco, Mariacristina, Fuccio, Lorenzo, Bertini, Federica, Guido, Alessandra, Herman, Joseph M., Macchia, Gabriella, Maidment, III, Bert W., Miller, Robert C., Minni, Francesco, Passoni, Paolo, Valentini, Chiara, Re, Alessia, Regine, William F., Reni, Michele, Falconi, Massimo, Valentini, Vincenzo, and Mattiucci, Gian Carlo

Published
2019
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26. New standards for the management of nose vestibule malignancies

Author

Bussu, Francesco, primary, Tagliaferri, Luca, additional, Crescio, Claudia, additional, Rizzo, Davide, additional, Gallus, Roberto, additional, Parrilla, Claudio, additional, Fionda, Bruno, additional, Lancellotta, Valentina, additional, Mattiucci, Gian Carlo, additional, and Galli, Jacopo, additional

Published
2023
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29. A deep learning approach to generate synthetic CT in low field MR-guided radiotherapy for lung cases

Author

Lenkowicz, Jacopo, primary, Votta, Claudio, additional, Nardini, Matteo, additional, Quaranta, Flaviovincenzo, additional, Catucci, Francesco, additional, Boldrini, Luca, additional, Vagni, Marica, additional, Menna, Sebastiano, additional, Placidi, Lorenzo, additional, Romano, Angela, additional, Chiloiro, Giuditta, additional, Gambacorta, Maria Antonietta, additional, Mattiucci, Gian Carlo, additional, Indovina, Luca, additional, Valentini, Vincenzo, additional, and Cusumano, Davide, additional

Published
2022
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32. Delta Radiomics Analysis for Local Control Prediction in Pancreatic Cancer Patients Treated Using Magnetic Resonance Guided Radiotherapy

Author

Cusumano, Davide, Boldrini, Luca, Yadav, Poonam, Casà, Calogero, Lee, Sangjune Laurence, Romano, Angela, Piras, Antonio, Chiloiro, Giuditta, Placidi, Lorenzo, Catucci, Francesco, Votta, Claudio, Mattiucci, Gian Carlo, Indovina, Luca, Gambacorta, Maria Antonietta, Bassetti, Michael, Valentini, Vincenzo, Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Cusumano, Davide, Boldrini, Luca, Yadav, Poonam, Casà, Calogero, Lee, Sangjune Laurence, Romano, Angela, Piras, Antonio, Chiloiro, Giuditta, Placidi, Lorenzo, Catucci, Francesco, Votta, Claudio, Mattiucci, Gian Carlo, Indovina, Luca, Gambacorta, Maria Antonietta, Bassetti, Michael, Valentini, Vincenzo, Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)

Abstract

The aim of this study is to investigate the role of Delta Radiomics analysis in the prediction of one-year local control (1yLC) in patients affected by locally advanced pancreatic cancer (LAPC) and treated using Magnetic Resonance guided Radiotherapy (MRgRT). A total of 35 patients from two institutions were enrolled: A 0.35 Tesla T2*/T1 MR image was acquired for each case during simulation and on each treatment fraction. Physical dose was converted in biologically effective dose (BED) to compensate for different radiotherapy schemes. Delta Radiomics analysis was performed considering the gross tumour volume (GTV) delineated on MR images acquired at BED of 20, 40, and 60 Gy. The performance of the delta features in predicting 1yLC was investigated in terms of Wilcoxon Mann-Whitney test and area under receiver operating characteristic (ROC) curve (AUC). The most significant feature in predicting 1yLC was the variation of cluster shade calculated at BED = 40 Gy, with a p-value of 0.005 and an AUC of 0.78 (0.61-0.94). Delta Radiomics analysis on low-field MR images might play a promising role in 1yLC prediction for LAPC patients: further studies including an external validation dataset and a larger cohort of patients are recommended to confirm the validity of this preliminary experience.

Published
2021

33. Comparative Effectiveness of Chemotherapy Alone Versus Radiotherapy-Based Regimens in Locally Advanced Pancreatic Cancer: A Real-World Multicenter Analysis (PAULA-1).

Author

Arcelli, Alessandra, Tarantino, Giuseppe, Cellini, Francesco, Buwenge, Milly, Macchia, Gabriella, Bertini, Federica, Guido, Alessandra, Deodato, Francesco, Cilla, Savino, Scotti, Valerio, Rosetto, Maria Elena, Djan, Igor, Parisi, Salvatore, Mattiucci, Gian Carlo, Fiore, Michele, Bonomo, Pierluigi, Belgioia, Liliana, Niespolo, Rita Marina, Gabriele, Pietro, and Di Marco, Mariacristina

Subjects
PANCREATIC cancer, STEREOTACTIC radiotherapy, CANCER chemotherapy, CHEMORADIOTHERAPY, OVERALL survival
Abstract

Different options for locally advanced pancreatic cancer (LAPC) are available based on international guidelines: chemotherapy (CHT), chemoradiation (CRT), and stereotactic body radiotherapy (SBRT). However, the role of radiotherapy is debated in LAPC. We retrospectively compared CHT, CRT, and SBRT ± CHT in a real-world setting in terms of overall survival (OS), local control (LC), and distant metastasis-free survival (DMFS). LAPC patients from a multicentric retrospective database were included (2005–2018). Survival curves were calculated using the Kaplan–Meier method. Multivariable Cox analysis was performed to identify predictors of LC, OS, and DMFS. Of the 419 patients included, 71.1% were treated with CRT, 15.5% with CHT, and 13.4% with SBRT. Multivariable analysis showed higher LC rates for CRT (HR: 0.56, 95%CI 0.34–0.92, p = 0.022) or SBRT (HR: 0.27, 95%CI 0.13–0.54, p < 0.001), compared to CHT. CRT (HR: 0.44, 95%CI 0.28–0.70, p < 0.001) and SBRT (HR: 0.40, 95%CI 0.22–0.74, p = 0.003) were predictors of prolonged OS with respect to CHT. No significant differences were recorded in terms of DMFS. In selected patients, the addition of radiotherapy to CHT is still an option to be considered. In patients referred for radiotherapy, CRT can be replaced by SBRT considering its duration, higher LC rate, and OS rate, which are at least comparable to that of CRT. [ABSTRACT FROM AUTHOR]

Published
2023
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34. Evaluation of Staging Systems for Cancer of the Nasal Vestibule.

Author

Scheurleer, Willem Frederik Julius, Tagliaferri, Luca, Rijken, Johannes A., Crescio, Claudia, Rizzo, Davide, Mattiucci, Gian Carlo, Pameijer, Frank A., de Bree, Remco, Fionda, Bruno, de Ridder, Mischa, and Bussu, Francesco

Subjects
RESEARCH, HUMAN research subjects, RETROSPECTIVE studies, MAGNETIC resonance imaging, TUMOR classification, CANCER patients, INFORMED consent (Medical law), MEDICAL records, POSITRON emission tomography, DESCRIPTIVE statistics, NASAL tumors, SQUAMOUS cell carcinoma, LONGITUDINAL method
Abstract

Simple Summary: Cancer of the nasal vestibule is thought to be rare. Multiple staging systems exist for the staging of these tumors, which can lead to variability and, therefore, the poor reliability of data. This retrospective study aimed to evaluate these staging systems. One hundred and forty-eight patients with carcinoma of the nasal vestibule were included and re-staged per the available staging systems. Stage distribution varied widely between the four evaluated staging systems. The classification per Bussu et al. had the most balanced allocation of patients amongst the stages. The widespread adoption of a single system and the introduction of a designated topography code for this disease could lead to greater uniformity in data reporting and an improved understanding of the incidence and disease outcome. Further analysis of survival data is needed to assess which classification system is the best suited for nasal vestibule carcinoma. Squamous cell carcinoma of the nasal vestibule is reported to account for less than one percent of all head and neck malignancies. It lacks a designated WHO ICD-O topography code, and multiple systems are available for the staging of this disease, which results in unwanted variability and the subsequent poor reliability of data. The aim of this study was to evaluate the currently available staging systems for cancer of the nasal vestibule, including the recently introduced classification by Bussu et al., which built on Wang's original concept but with clearer anatomical cutoffs. Different staging systems for cancer of the nasal vestibule (UICC nasal cavity, UICC skin cancer of the head and neck, Wang and Bussu et al.) were evaluated via a retrospective analysis of 148 patients. The staging system, per Bussu et al., had the most balanced allocation of patients among the stages. When using the Wang classification as a reference, stage migration occurred less frequently with the Bussu classification. The widespread adoption of a single staging system, as well as the introduction of a designated topography code for cancer of the nasal vestibule, could lead to more uniformity in data reporting and improve an understanding of the incidence and disease outcome. The newly proposed carcinoma of the nasal vestibule classification by Bussu et al. has the potential to improve the staging and allocation among stages. Further analysis of survival data is needed to assess which classification system is best suited for nasal vestibule carcinoma. [ABSTRACT FROM AUTHOR]

Published
2023
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36. Clinical Validation of a Deep-Learning Segmentation Software in Head and Neck: An Early Analysis in a Developing Radiation Oncology Center

Author

D’Aviero, Andrea, primary, Re, Alessia, additional, Catucci, Francesco, additional, Piccari, Danila, additional, Votta, Claudio, additional, Piro, Domenico, additional, Piras, Antonio, additional, Di Dio, Carmela, additional, Iezzi, Martina, additional, Preziosi, Francesco, additional, Menna, Sebastiano, additional, Quaranta, Flaviovincenzo, additional, Boschetti, Althea, additional, Marras, Marco, additional, Miccichè, Francesco, additional, Gallus, Roberto, additional, Indovina, Luca, additional, Bussu, Francesco, additional, Valentini, Vincenzo, additional, Cusumano, Davide, additional, and Mattiucci, Gian Carlo, additional

Published
2022
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38. Modern Management of Esophageal Cancer: Radio-Oncology in Neoadjuvancy, Adjuvancy and Palliation

Author

Cellini, Francesco, Manfrida, Stefania, Casa, C., Romano, Angela, Arcelli, A., Zamagni, A., De Luca, V., Colloca, Giuseppe Ferdinando, D'Aviero, A., Fuccio, L., Lancellotta, V., Tagliaferri, Luca, Boldrini, Luca, Mattiucci, Gian Carlo, Gambacorta, Maria Antonietta, Morganti, Alessio Giuseppe, Valentini, Vincenzo, Cellini F. (ORCID:0000-0002-2145-2300), Manfrida S., Romano A., Colloca G. F., Tagliaferri L. (ORCID:0000-0003-2308-0982), Boldrini L., Mattiucci G. C. (ORCID:0000-0001-6500-0413), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Morganti A. G., Valentini V. (ORCID:0000-0003-4637-6487), Cellini, Francesco, Manfrida, Stefania, Casa, C., Romano, Angela, Arcelli, A., Zamagni, A., De Luca, V., Colloca, Giuseppe Ferdinando, D'Aviero, A., Fuccio, L., Lancellotta, V., Tagliaferri, Luca, Boldrini, Luca, Mattiucci, Gian Carlo, Gambacorta, Maria Antonietta, Morganti, Alessio Giuseppe, Valentini, Vincenzo, Cellini F. (ORCID:0000-0002-2145-2300), Manfrida S., Romano A., Colloca G. F., Tagliaferri L. (ORCID:0000-0003-2308-0982), Boldrini L., Mattiucci G. C. (ORCID:0000-0001-6500-0413), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Morganti A. G., and Valentini V. (ORCID:0000-0003-4637-6487)

Abstract

The modern management of esophageal cancer is crucially based on a multidisciplinary and multimodal approach. Radiotherapy is involved in neoadjuvant and adjuvant settings; moreover, it includes radical and palliative treatment intention (with a focus on the use of a stent and its potential integration with radiotherapy). In this review, the above-mentioned settings and approaches will be described. Referring to available international guidelines, the background evidence bases will be reviewed, and the ongoing, more relevant trials will be outlined. Target definitions and radiotherapy doses to administer will be mentioned. Peculiar applications such as brachytherapy (interventional radiation oncology), and data regarding innovative approaches including MRI-guided-RT and radiomic analysis will be reported. A focus on the avoidance of surgery for major clinical responses (particularly for SCC) is detailed.

Published
2022

39. The impact of radiomics in diagnosis and staging of pancreatic cancer

Author

Casa, Cristina, Piras, A., D'Aviero, A., Preziosi, Francesco, Mariani, Silvia, Cusumano, Davide, Romano, Angela, Boskoski, Ivo, Lenkowicz, Jacopo, Dinapoli, Nicola, Cellini, Francesco, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Mattiucci, Gian Carlo, Boldrini, Luca, Casa C., Preziosi F., Mariani S., Cusumano D., Romano A., Boskoski I. (ORCID:0000-0001-8194-2670), Lenkowicz J., Dinapoli N., Cellini F. (ORCID:0000-0002-2145-2300), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Valentini V. (ORCID:0000-0003-4637-6487), Mattiucci G. C. (ORCID:0000-0001-6500-0413), Boldrini L., Casa, Cristina, Piras, A., D'Aviero, A., Preziosi, Francesco, Mariani, Silvia, Cusumano, Davide, Romano, Angela, Boskoski, Ivo, Lenkowicz, Jacopo, Dinapoli, Nicola, Cellini, Francesco, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Mattiucci, Gian Carlo, Boldrini, Luca, Casa C., Preziosi F., Mariani S., Cusumano D., Romano A., Boskoski I. (ORCID:0000-0001-8194-2670), Lenkowicz J., Dinapoli N., Cellini F. (ORCID:0000-0002-2145-2300), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Valentini V. (ORCID:0000-0003-4637-6487), Mattiucci G. C. (ORCID:0000-0001-6500-0413), and Boldrini L.

Abstract

Introduction: Pancreatic cancer (PC) is one of the most aggressive tumours, and better risk stratification among patients is required to provide tailored treatment. The meaning of radiomics and texture analysis as predictive techniques are not already systematically assessed. The aim of this study is to assess the role of radiomics in PC. Methods: A PubMed/MEDLINE and Embase systematic review was conducted to assess the role of radiomics in PC. The search strategy was ‘radiomics [All Fields] AND (“pancreas” [MeSH Terms] OR “pancreas” [All Fields] OR “pancreatic” [All Fields])’ and only original articles referred to PC in humans in the English language were considered. Results: A total of 123 studies and 183 studies were obtained using the mentioned search strategy on PubMed and Embase, respectively. After the complete selection process, a total of 56 papers were considered eligible for the analysis of the results. Radiomics methods were applied in PC for assessment technical feasibility and reproducibility aspects analysis, risk stratification, biologic or genomic status prediction and treatment response prediction. Discussion: Radiomics seems to be a promising approach to evaluate PC from diagnosis to treatment response prediction. Further and larger studies are required to confirm the role and allowed to include radiomics parameter in a comprehensive decision support system.

Published
2022

41. Dosimetric Impact of Inter-Fraction Variability in the Treatment of Breast Cancer: Towards New Criteria to Evaluate the Appropriateness of Online Adaptive Radiotherapy

Author

Iezzi, Martina, primary, Cusumano, Davide, additional, Piccari, Danila, additional, Menna, Sebastiano, additional, Catucci, Francesco, additional, D’Aviero, Andrea, additional, Re, Alessia, additional, Di Dio, Carmela, additional, Quaranta, Flaviovincenzo, additional, Boschetti, Althea, additional, Marras, Marco, additional, Piro, Domenico, additional, Tomei, Flavia, additional, Votta, Claudio, additional, Valentini, Vincenzo, additional, and Mattiucci, Gian Carlo, additional

Published
2022
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44. Prevalence of HPV Infection and p16INK4a Overexpression in Surgically Treated Laryngeal Squamous Cell Carcinoma

Author

Gallus, Roberto, primary, Gheit, Tarik, additional, Holzinger, Dana, additional, Petrillo, Marco, additional, Rizzo, Davide, additional, Petrone, Gianluigi, additional, Miccichè, Francesco, additional, Mattiucci, Gian Carlo, additional, Arciuolo, Damiano, additional, Capobianco, Giampiero, additional, Delogu, Giovanni, additional, Valentini, Vincenzo, additional, Tommasino, Massimo, additional, and Bussu, Francesco, additional

Published
2022
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45. Modern Management of Esophageal Cancer: Radio-Oncology in Neoadjuvancy, Adjuvancy and Palliation

Author

Cellini, Francesco, primary, Manfrida, Stefania, additional, Casà, Calogero, additional, Romano, Angela, additional, Arcelli, Alessandra, additional, Zamagni, Alice, additional, De Luca, Viola, additional, Colloca, Giuseppe Ferdinando, additional, D’Aviero, Andrea, additional, Fuccio, Lorenzo, additional, Lancellotta, Valentina, additional, Tagliaferri, Luca, additional, Boldrini, Luca, additional, Mattiucci, Gian Carlo, additional, Gambacorta, Maria Antonietta, additional, Morganti, Alessio Giuseppe, additional, and Valentini, Vincenzo, additional

Published
2022
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46. The impact of radiomics in diagnosis and staging of pancreatic cancer

Author

Casà, Calogero, primary, Piras, Antonio, additional, D’Aviero, Andrea, additional, Preziosi, Francesco, additional, Mariani, Silvia, additional, Cusumano, Davide, additional, Romano, Angela, additional, Boskoski, Ivo, additional, Lenkowicz, Jacopo, additional, Dinapoli, Nicola, additional, Cellini, Francesco, additional, Gambacorta, Maria Antonietta, additional, Valentini, Vincenzo, additional, Mattiucci, Gian Carlo, additional, and Boldrini, Luca, additional

Published
2022
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47. Role of Chemoradiation in the Adjuvant Treatment of Radically Resected Pancreatic Cancer Patients: A Mono-Institutional Retrospective Analysis

Author

Mattiucci, Gian Carlo, primary, Salvatore, Lisa, additional, D’Aviero, Andrea, additional, Bagalà, Cinzia, additional, Bensi, Maria, additional, Castronovo, Francesco Mosè, additional, Cellini, Francesco, additional, De Franco, Paola, additional, Di Stefano, Brunella, additional, Macchia, Gabriella, additional, Masiello, Valeria, additional, Menghi, Roberta, additional, Quero, Giuseppe, additional, Reina, Sara, additional, Morganti, Alessio Giuseppe, additional, Alfieri, Sergio, additional, Tortora, Giampaolo, additional, and Valentini, Vincenzo, additional

Published
2022
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50. Adjuvant chemoradiation in pancreatic cancer: impact of radiotherapy dose on survival

Author

Morganti, Alessio Giuseppe, Cellini, Francesco, Buwenge, Milly, Arcelli, Alessandra, Alfieri, Sergio, Calvo, Felipe A, Casadei, Riccardo, Cilla, Savino, Deodato, Francesco, Di Gioia, Giancarmine, Di Marco, Mariacristina, Fuccio, Lorenzo, Bertini, Federica, Guido, Alessandra, Herman, Joseph M, Macchia, Gabriella, Maidment, Bert W, Miller, Robert C, Minni, Francesco, Passoni, Paolo, Valentini, Chiara, Perego, Alessia, Regine, William F, Reni, Michele, Falconi, Massimo, Valentini, Vincenzo, Mattiucci, Gian Carlo, Morganti, Alessio G, Cellini, Francesco (ORCID:0000-0002-2145-2300), Alfieri, Sergio (ORCID:0000-0002-0404-724X), Deodato, Francesco (ORCID:0000-0003-1276-5070), Re, Alessia, Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Morganti, Alessio Giuseppe, Cellini, Francesco, Buwenge, Milly, Arcelli, Alessandra, Alfieri, Sergio, Calvo, Felipe A, Casadei, Riccardo, Cilla, Savino, Deodato, Francesco, Di Gioia, Giancarmine, Di Marco, Mariacristina, Fuccio, Lorenzo, Bertini, Federica, Guido, Alessandra, Herman, Joseph M, Macchia, Gabriella, Maidment, Bert W, Miller, Robert C, Minni, Francesco, Passoni, Paolo, Valentini, Chiara, Perego, Alessia, Regine, William F, Reni, Michele, Falconi, Massimo, Valentini, Vincenzo, Mattiucci, Gian Carlo, Morganti, Alessio G, Cellini, Francesco (ORCID:0000-0002-2145-2300), Alfieri, Sergio (ORCID:0000-0002-0404-724X), Deodato, Francesco (ORCID:0000-0003-1276-5070), Re, Alessia, Valentini, Vincenzo (ORCID:0000-0003-4637-6487), and Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413)

Abstract

N/A

Published
2019

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