{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:07:05Z","timestamp":1760234825530,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T00:00:00Z","timestamp":1623974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>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 mesenteric artery (SMA) were reported in 32.8% and 67.2% cases, respectively. The mean (\u00b1 standard deviation) distances of LF points to CA and SMA were 21.5 \u00b1 17.9 mm and 21.6 \u00b1 12.1 mm, respectively. The Dice values comparing our iso-level risk maps corresponding to 80% and 90% of the LF probabilistic density and the CTVs-80 and CTVs-90 of previous publications were 0.45\u20130.53 and 0.58\u20130.60, 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.<\/jats:p>","DOI":"10.3390\/cancers13123051","type":"journal-article","created":{"date-parts":[[2021,6,20]],"date-time":"2021-06-20T22:00:02Z","timestamp":1624226402000},"page":"3051","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Definition of Local Recurrence Site in Resected Pancreatic Adenocarcinoma: A Multicenter Study (DOLORES-1)"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0253-8958","authenticated-orcid":false,"given":"Alessandra","family":"Arcelli","sequence":"first","affiliation":[{"name":"Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Experimental, Diagnostic and Specialty Medicine\u2013DIMES, Alma Mater Studiorum, Bologna University, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Bertini","sequence":"additional","affiliation":[{"name":"Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Experimental, Diagnostic and Specialty Medicine\u2013DIMES, Alma Mater Studiorum, Bologna University, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Strolin","sequence":"additional","affiliation":[{"name":"Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Macchia","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Gemelli Molise Hospital, Universit\u00e0 Cattolica del Sacro Cuore, 86100 Campobasso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1276-5070","authenticated-orcid":false,"given":"Francesco","family":"Deodato","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Gemelli Molise Hospital, Universit\u00e0 Cattolica del Sacro Cuore, 86100 Campobasso, Italy"},{"name":"Istituto di Radiologia, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Savino","family":"Cilla","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, Gemelli Molise Hospital, Universit\u00e0 Cattolica del Sacro Cuore, 86100 Campobasso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Parisi","sequence":"additional","affiliation":[{"name":"Unit of Radiation Therapy, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldo","family":"Sainato","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Pisa University Hospital, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1889-4578","authenticated-orcid":false,"given":"Michele","family":"Fiore","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Campus Bio-Medico University, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Gabriele","sequence":"additional","affiliation":[{"name":"Radiation Therapy, Candiolo Cancer Institute\u2013FPO, IRCCS Candiolo, 10060 Candiolo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Genovesi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, SS. Annunziata Hospital, G. D\u2019Annunzio University of Chieti, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Cellini","sequence":"additional","affiliation":[{"name":"Istituto di Radiologia, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Guido","sequence":"additional","affiliation":[{"name":"Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2111-0164","authenticated-orcid":false,"given":"Silvia","family":"Cammelli","sequence":"additional","affiliation":[{"name":"Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Experimental, Diagnostic and Specialty Medicine\u2013DIMES, Alma Mater Studiorum, Bologna University, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milly","family":"Buwenge","sequence":"additional","affiliation":[{"name":"Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Experimental, Diagnostic and Specialty Medicine\u2013DIMES, Alma Mater Studiorum, Bologna University, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emiliano","family":"Loi","sequence":"additional","affiliation":[{"name":"Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Bisello","sequence":"additional","affiliation":[{"name":"Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Experimental, Diagnostic and Specialty Medicine\u2013DIMES, Alma Mater Studiorum, Bologna University, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1311-5670","authenticated-orcid":false,"given":"Matteo","family":"Renzulli","sequence":"additional","affiliation":[{"name":"Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8809-9989","authenticated-orcid":false,"given":"Rita","family":"Golfieri","sequence":"additional","affiliation":[{"name":"Department of Experimental, Diagnostic and Specialty Medicine\u2013DIMES, Alma Mater Studiorum, Bologna University, 40138 Bologna, Italy"},{"name":"Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9793-3410","authenticated-orcid":false,"given":"Alessio G.","family":"Morganti","sequence":"additional","affiliation":[{"name":"Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Experimental, Diagnostic and Specialty Medicine\u2013DIMES, Alma Mater Studiorum, Bologna University, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4293-2298","authenticated-orcid":false,"given":"Lidia","family":"Strigari","sequence":"additional","affiliation":[{"name":"Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21551","article-title":"Cancer statistics, 2019","volume":"69","author":"Siegel","year":"2019","journal-title":"CA Cancer J. 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