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Pancreatic Neoplasms: HELP
Articles by Francesco Cellini
Based on 8 articles published since 2009
(Why 8 articles?)
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Between 2009 and 2019, Francesco Cellini wrote the following 8 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Online adaptive magnetic resonance guided radiotherapy for pancreatic cancer: state of the art, pearls and pitfalls. 2019

Boldrini, Luca / Cusumano, Davide / Cellini, Francesco / Azario, Luigi / Mattiucci, Gian Carlo / Valentini, Vincenzo. ·Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italia. · Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Fisica Sanitaria, Fondazione Policlinico Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italia. davide.cusumano@policlinicogemelli.it. · Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Fisica Sanitaria, Fondazione Policlinico Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italia. ·Radiat Oncol · Pubmed #31036034.

ABSTRACT: BACKGROUND: Different studies have proved in recent years that hypofractionated radiotherapy (RT) improves overall survival of patients affected by locally advanced, unresectable, pancreatic cancer. The clinical management of these patients generally leads to poor results and is considered very challenging, due to different factors, heavily influencing treatment delivery and its outcomes. Firstly, the dose prescribed to the target is limited by the toxicity that the highly radio-sensitive organs at risk (OARs) surrounding the disease can develop. Treatment delivery is also complicated by the significant inter-fractional and intra-fractional variability of therapy volumes, mainly related to the presence of hollow organs and to the breathing cycle. The recent introduction of magnetic resonance guided radiotherapy (MRgRT) systems leads to the opportunity to control most of the aforementioned sources of uncertainty influencing RT treatment workflow in pancreatic cancer. MRgRT offers the possibility to accurately identify radiotherapy volumes, thanks to the high soft-tissue contrast provided by the Magnetic Resonance imaging (MRI), and to monitor the tumour and OARs positions during the treatment fraction using a high-temporal cine MRI. However, the main advantage offered by the MRgRT is the possibility to online adapt the RT treatment plan, changing the dose distribution while the patient is still on couch and successfully addressing most of the sources of variability. SHORT CONCLUSION: Aim of this study is to present and discuss the state of the art, the main pitfalls and the innovative opportunities offered by online adaptive MRgRT in pancreatic cancer treatment.

2 Review Stereotactic radiotherapy of pancreatic cancer: a systematic review on pain relief. 2018

Buwenge, Milly / Macchia, Gabriella / Arcelli, Alessandra / Frakulli, Rezarta / Fuccio, Lorenzo / Guerri, Sara / Grassi, Elisa / Cammelli, Silvia / Cellini, Francesco / Morganti, Alessio G. ·Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy, rt.unibo@gmail.com. · Radiation Oncology Unit, Research and Care Foundation "Giovanni Paolo II", Catholic University of Sacred Heart, Campobasso, Italy. · Radiation Oncology Unit, Bellaria Hospital, Bologna, Italy. · Department of Medical and Surgical Sciences - DIMEC, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. · Department of Radiotherapy, "A. Gemelli" Hospital, Catholic University, Rome, Italy. ·J Pain Res · Pubmed #30323651.

ABSTRACT: Locally advanced pancreatic carcinoma (LAPC) has a poor prognosis and the purpose of treatment is survival prolongation and symptom palliation. Radiotherapy has been reported to reduce pain in LAPC. Stereotactic RT (SBRT) is considered as an emerging radiotherapy technique able to achieve high local control rates with acceptable toxicity. However, its role in pain palliation is not clear. To review the impact on pain relief with SBRT in LAPC patients, a literature search was performed on PubMed, Scopus, and Embase (January 2000-December 2017) for prospective and retrospective articles published in English. Fourteen studies (479 patients) reporting the effect of SBRT on pain relief were finally included in this analysis. SBRT was delivered with both standard and/or robotic linear accelerators. The median prescribed SBRT doses ranged from 16.5 to 45 Gy (median: 27.8 Gy), and the number of fractions ranged from 1 to 6 (median: 3.5). Twelve of the 14 studies reported the percentage of pain relief (in patients with pain at presentation) with a global overall response rate (complete and partial response) of 84.9% (95% CI, 75.8%-91.5%), with high heterogeneity (

3 Review Multimodal treatment of resectable pancreatic ductal adenocarcinoma. 2017

Silvestris, Nicola / Brunetti, Oronzo / Vasile, Enrico / Cellini, Francesco / Cataldo, Ivana / Pusceddu, Valeria / Cattaneo, Monica / Partelli, Stefano / Scartozzi, Mario / Aprile, Giuseppe / Casadei Gardini, Andrea / Morganti, Alessio Giuseppe / Valentini, Vincenzo / Scarpa, Aldo / Falconi, Massimo / Calabrese, Angela / Lorusso, Vito / Reni, Michele / Cascinu, Stefano. ·Medical Oncology Unit, Cancer Institute "Giovanni Paolo II", Bari, Italy. Electronic address: n.silvestris@oncologico.bari.it. · Medical Oncology Unit, Cancer Institute "Giovanni Paolo II", Bari, Italy. Electronic address: dr.oronzo.brunetti@tiscali.it. · Department of Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. Electronic address: e.vasile@ao.pisa.toscana.it. · Radiation Oncology Department, Gemelli ART, Università Cattolica del Sacro Cuore, Roma, Italy. Electronic address: francesco.cellini@uniroma3.it. · ARC-NET Research Centre, University of Verona, Verona, Italy. Electronic address: cataldo.ivana@gmail.com. · Medical Oncology Unit, University of Cagliari, Cagliari, Italy. Electronic address: oncologiamedica2reparto@gmail.com. · Department of Medical Oncology, University and General Hospital, Udine, Italy. Electronic address: aprile83@gmail.com. · Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, 'Vita-Salute' University, Milan, Italy. Electronic address: partelli.stefano@hsr.it. · Medical Oncology Unit, University of Cagliari, Cagliari, Italy. Electronic address: marioscartozzi@gmail.com. · Department of Medical Oncology, University and General Hospital, Udine, Italy; Department of Medical Oncology, General Hospital of Vicenza, Vicenza, Italy. Electronic address: aprile.giuseppe@aoud.sanita.fvg.it. · Medical Oncology Unit, IRCCS, Meldola, Italy. Electronic address: casadeigardini@gmail.com. · Radiation Oncology Center, Dept. of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, Italy. Electronic address: alessio.morganti2@unibo.it. · Radiation Oncology Department, Gemelli ART, Università Cattolica del Sacro Cuore, Roma, Italy. Electronic address: vincenzo.valentini@unicatt.it. · ARC-NET Research Centre, University of Verona, Verona, Italy. Electronic address: aldo.scarpa@univr.it. · Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, 'Vita-Salute' University, Milan, Italy. Electronic address: falconi.massimo@hsr.it. · Radiology Unit, Cancer Institute "Giovanni Paolo II", Bari, Italy. Electronic address: acalabrese22@gmail.com. · Medical Oncology Unit, Cancer Institute "Giovanni Paolo II", Bari, Italy. Electronic address: vito.lorusso@oncologico.bari.it. · Medical Oncology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: reni.michele@hsr.it. · Modena Cancer Center, Policlinico di Modena Università di Modena e Reggio Emilia, Italy. Electronic address: cascinu@yahoo.com. ·Crit Rev Oncol Hematol · Pubmed #28259290.

ABSTRACT: After a timing preoperative staging, treatment of resectable pancreatic adenocarcinoma (PDAC) includes surgery and adjuvant therapies, the former representing the initial therapeutic option and the latter aiming to reduce the incidence of both distant metastases (chemotherapy) and locoregional failures (chemoradiotherapy). Herein, we provide a critical overview on the role of multimodal treatment in PDAC and on new opportunities related to current more active poli-chemotherapy regimens, targeted therapies, and the more recent immunotherapy approaches. Moreover, an analysis of pathological markers and clinical features able to help clinicians in the selection of the best therapeutic strategy will be discussed. Lastly, the role of neoadjuvant treatment of initially resectable disease will be considered mostly in patients whose malignancy shows morphological but not clinical or biological criteria of resectability. Depending on the results of these investigational studies, today a multidisciplinary approach can offer the best address therapy for these patients.

4 Review Neoadjuvant multimodal treatment of pancreatic ductal adenocarcinoma. 2016

Silvestris, Nicola / Longo, Vito / Cellini, Francesco / Reni, Michele / Bittoni, Alessandro / Cataldo, Ivana / Partelli, Stefano / Falconi, Massimo / Scarpa, Aldo / Brunetti, Oronzo / Lorusso, Vito / Santini, Daniele / Morganti, Alessio / Valentini, Vincenzo / Cascinu, Stefano. ·Medical Oncology Unit, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy. Electronic address: n.silvestris@oncologico.bari.it. · Medical Oncology Unit, 'Mons R Dimiccoli' Hospital, Barletta, Italy. · Radiation Oncology Department, Policlinico Universitario Campus Bio-Medico, Rome, Italy. · Medical Oncology Department, IRCCS San Raffaele Scientific Institute, Milano, Italy. · Medical Oncology Clinic, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, Italy. · ARC-NET Research Centre, University of Verona, Italy. · Pancreatic Unit, Department of Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy. · Medical Oncology Unit, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy. · Medical Oncology Unit, University Campus Biomedico, Roma, Italy. · Radiation Oncology Center, Dept. of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, Italy. ·Crit Rev Oncol Hematol · Pubmed #26653573.

ABSTRACT: Treatment of pancreatic ductal adenocarcinoma (PDAC) is increasingly multidisciplinary, with neoadjuvant strategies (chemotherapy, radiation, and surgery) administered in patients with resectable, borderline resectable, or locally advanced disease. The rational supporting this management is the achievement of both higher margin-negative resections and conversion rates into potentially resectable disease and in vivo assessment of novel therapeutics. International guidelines suggest an initial staging of the disease followed by a multidisciplinary approach, even considering the lack of a treatment approach to be considered as standard in this setting. This review will focus on both literature data supporting these guidelines and on new opportunities related to current more active chemotherapy regimens. An analysis of the pathological assessment of response to therapy and the potential role of target therapies and translational biomarkers and ongoing clinical trials of significance will be discussed.

5 Review Robotic radiosurgery in pancreatic cancer: A systematic review. 2015

Buwenge, Milly / Cellini, Francesco / Silvestris, Nicola / Cilla, Savino / Deodato, Francesco / Macchia, Gabriella / Mattiucci, Gian C / Valentini, Vincenzo / Morganti, Alessio G. ·Milly Buwenge, Francesco Deodato, Gabriella Macchia, Department of Radiation Oncology, Università Cattolica del Sacro Cuore, 86100 Campobasso, Italy. ·World J Gastroenterol · Pubmed #26309369.

ABSTRACT: AIM: To present a systematic review of techniques and clinical results. METHODS: A systematic review of published literature was performed. Only studies reporting patient outcome after radiosurgery (single fraction) delivered with robotic devices [i.e., robotic radiosurgery (RRS)] have been analyzed. RESULTS: A total of 96 patients from 5 studies were included. The studies are characterized by small series and different methods in terms of dose, target definition, combination with chemotherapy and/or standard fractionated radiotherapy and evaluation modalities. Preliminary results are positive in terms of tumor response (ORR = 56%) and local control of the tumor (crude rate of local progressions: 19.5%). Results for median overall survival (11.4 mo) seem comparable with the ones of prolonged chemoradiation (range: 8.6-13.0 mo). However, gastrointestinal toxicity seems to be the main limitation of RRS, especially at the duodenal level. CONCLUSION: RRS allows for local treatment in a shortened time (1 fraction) compared to traditional treatments (about 1 mo), providing the possibility for an easy integration with systemic therapies. Preliminary results did not show any outcome differences compared to standard chemoradiation. Thus, further efforts to reduce gastrointestinal toxicity are strongly needed.

6 Article Magnetic resonance imaging (MRI) compared with computed tomography (CT) for interobserver agreement of gross tumor volume delineation in pancreatic cancer: a multi-institutional contouring study on behalf of the AIRO group for gastrointestinal cancers. 2019

Caravatta, Luciana / Cellini, Francesco / Simoni, Nicola / Rosa, Consuelo / Niespolo, Rita Marina / Lupattelli, Marco / Picardi, Vincenzo / Macchia, Gabriella / Sainato, Aldo / Mantello, Giovanna / Dionisi, Francesco / Rosetto, Maria Elena / Fusco, Vincenzo / Navarria, Federico / De Paoli, Antonino / Guido, Alessandra / Vecchi, Claudio / Basilico, Raffaella / Cianci, Roberta / Delli Pizzi, Andrea / Di Nicola, Marta / Mattiucci, Gian Carlo / Valentini, Vincenzo / Morganti, Alessio Giuseppe / Genovesi, Domenico. ·a Department of Radiotherapy , 'SS Annunziata' Hospital 'G. D'Annunzio' University , Chieti , Italy. · b Gemelli Advanced Radiation Therapy Center Fondazione Policlinico Universitario 'A. Gemelli' Catholic University of Sacred Heart , Rome , Italy. · c Radiotherapy Unit Azienda Ospedaliera Universitaria , Verona , Italy. · d Department of Radiation Oncology , Azienda Ospedaliera S. Gerardo , Monza , Italy. · e Radiation Oncology Section University of Perugia and Perugia General Hospital , Perugia , Italy. · f Radiotherapy Unit Department of Oncology , 'Giovanni Paolo II' Foundation Catholic University of Sacred Heart , Campobasso , Italy. · g Radiotherapy Unit , Azienda Ospedaliera Universitaria Pisana , Pisa , Italy. · h Department of Radiotherapy , State Hospital , Ancona , Italy. · i Proton Therapy Unit, Department of Oncology , Azienda Provinciale per i Servizi Sanitari, APSS , Trento , Italy. · j Department of Radiation Oncology , Ospedale Belcolle , Viterbo , Italy. · k Department of Radiation Oncology , Centro di Riferimento Oncologico Regionale , Rionero in Vulture, Potenza , Italy. · l Department of Radiation Oncology Centro di Riferimento Oncologico , National Cancer Institute , Aviano , Italy. · m Radiation Oncology Center, Department of Experimental Diagnostic and Specialty Medicine - DIMES , University of Bologna, S. Orsola-Malpighi Hospital , Bologna , Italy. · n Tecnologie Avanzate, Srl , Torino , Italy. · o Department of Radiology , 'SS Annunziata' Hospital 'G. D'Annunzio' University , Chieti , Italy. · p Laboratory of Biostatistics Department of Medical , Oral and Biotechnological Sciences 'G. D'Annunzio' University , Chieti , Italy. ·Acta Oncol · Pubmed #30632876.

ABSTRACT: BACKGROUND: Due to the high soft tissue resolution, magnetic resonance imaging (MRI) could improve the accuracy of pancreatic tumor delineation in radiation treatment planning. A multi-institutional study was proposed to evaluate the impact of MRI on inter-observer agreement in gross tumor volume (GTV) and duodenum delineation for pancreatic cancer compared with computer tomography (CT). MATERIAL AND METHODS: Two clinical cases of borderline resectable (Case 1) and unresectable (Case 2) pancreatic cancer were selected. In two sequential steps, diagnostic contrast-enhanced CT scan and MRI sequences were sent to the participating centers. CT-GTVs were contoured while blinded to MRI data sets. DICE index was used to evaluate the spatial overlap accuracy. RESULTS: Thirty-one radiation oncologists from different Institutions submitted the delineated volumes. CT- and MRI-GTV mean volumes were 21.6 ± 9.0 cm CONCLUSION: Diagnostic MRI resulted in smaller GTV in borderline resectable case with a substantial agreement between observers, and was comparable to CT scan in interobserver variability, in both cases. The greater variability in the unresectable case underlines the critical issues related to the outlining when vascular structures are more involved. The integration of MRI with contrast-enhancement CT, thanks to its high definition of tumor relationship with neighboring vessels, could offer a greater accuracy of target delineation.

7 Article Predicting tumour motion during the whole radiotherapy treatment: a systematic approach for thoracic and abdominal lesions based on real time MR. 2018

Cusumano, Davide / Dhont, Jennifer / Boldrini, Luca / Chiloiro, Giuditta / Teodoli, Stefania / Massaccesi, Mariangela / Fionda, Bruno / Cellini, Francesco / Azario, Luigi / Vandemeulebroucke, Jef / De Spirito, Marco / Valentini, Vincenzo / Verellen, Dirk. ·U.O.C. Fisica Sanitaria, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italia; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia. · Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Pleinlaan 2, B-1050 Brussels, Belgium; Vrije Universiteit Brussel (VUB), Department of Electronics and Informatics (ETRO), Pleinlaan 2, B-1050 Brussels, Belgium; imec, Kapeldreef 75, B-3001 Leuven, Belgium. · Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia. Electronic address: luca.boldrini@unicatt.it. · Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia; U.O.C. Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Roma, Italia. · U.O.C. Fisica Sanitaria, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italia. · U.O.C. Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Roma, Italia. · U.O.C. Fisica Sanitaria, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italia; Istituto di Fisica, Università Cattolica del Sacro Cuore, Roma, Italia. · Vrije Universiteit Brussel (VUB), Department of Electronics and Informatics (ETRO), Pleinlaan 2, B-1050 Brussels, Belgium; imec, Kapeldreef 75, B-3001 Leuven, Belgium. · Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Pleinlaan 2, B-1050 Brussels, Belgium; Department of Radiotherapy, GZA Ziekenhuizen - Sint Augustinus, Iridium Kankernetwerk, Antwerp, Belgium. ·Radiother Oncol · Pubmed #30144955.

ABSTRACT: INTRODUCTION: Aim of this study was to investigate the ability of pre-treatment four dimensional computed tomography (4DCT) to capture respiratory-motion observed in thoracic and abdominal lesions during treatment. Treatment motion was acquired using full-treatment cine-MR acquisitions. Results of this analysis were compared to the ability of 30 seconds (s) cine Magnetic Resonance (MR) to estimate the same parameters. METHODS: A 4DCT and 30 s cine-MR (ViewRay, USA) were acquired on the simulation day for 7 thoracic and 13 abdominal lesions. Mean amplitude, intra- and inter-fraction amplitude variability, and baseline drift were extracted from the full treatment data acquired by 2D cine-MR, and correlated to the motion on pre-treatment 30 s cine-MR and 4DCT. Using the full treatment data, safety margins on the ITV, necessary to account for all motion variability from 4DCT observed during treatment, were calculated. Mean treatment amplitudes were 2 ± 1 mm and 5 ± 3 mm in the anteroposterior (AP) and craniocaudal (CC) direction, respectively. Differences between mean amplitude during treatment and amplitude on 4DCT or during 30 s cine-MR were not significant, but 30 s cine-MR was more accurate than 4DCT. Intra-fraction amplitude variability was positively correlated with both 30 s cine-MR and 4DCT amplitude. Inter-fraction amplitude variability was minimal. RESULTS: Mean baseline drift over all fractions and patients equalled 1 ± 1 mm in both CC and AP direction, but drifts per fraction up to 16 mm (CC) and 12 mm (AP) were observed. Margins necessary on the ITV ranged from 0 to 8 mm in CC and 0 to 5 mm in AP direction. Neither amplitude on 4DCT nor during 30 s cine MR is correlated to the magnitude of drift or the necessary margins in both directions. CONCLUSION: Lesions moving with small amplitude show limited amplitude variability throughout treatment, making passive motion management strategies seem adequate. However, other variations such as baseline drifts and shifts still cause significant geometrical uncertainty, favouring real-time monitoring and an active approach for all lesions influenced by respiratory motion.

8 Article Individually optimized stereotactic radiotherapy for pancreatic head tumors: A planning feasibility study. 2016

Buwenge, Milly / Cilla, Savino / Guido, Alessandra / Giaccherini, Lucia / Macchia, Gabriella / Deodato, Francesco / Cammelli, Silvia / Cellini, Francesco / Mattiucci, Gian C / Valentini, Vincenzo / Stock, Markus / Morganti, Alessio G. ·Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. · Medical Physic Unit, Fondazione "Giovanni Paolo II", Catholic University of Sacred Heart, Campobasso, Italy. · Radiotherapy Unit, Fondazione "Giovanni Paolo II", Catholic University of Sacred Heart, Campobasso, Italy. · Radiation Oncology Department, Università Cattolica del Sacro Cuore, Rome, Italy. · EBG MedAustron, Wiener Neustadt, Austria. ·Rep Pract Oncol Radiother · Pubmed #27708554.

ABSTRACT: AIM: Aim of this study was to perform a planning feasibility analysis of a 3-level dose prescription using an IMRT-SIB technique. BACKGROUND: Radiation therapy of locally advanced pancreatic cancer should administer a minimum dose to the duodenum and a very high dose to the vascular infiltration areas to improve the possibility of a radical resection. MATERIALS AND METHODS: Fifteen patients with pancreatic head adenocarcinoma and vascular involvement were included. The duodenal PTV (PTVd) was defined as the GTV overlapping the duodenal PRV. Vascular CTV (CTVv) was defined as the surface of contact or infiltration between the tumor and vessel plus a 5 mm margin. Vascular PTV (PTVv) was considered as the CTVv plus an anisotropic margin. The tumor PTV (PTVt) was defined as the GTV plus a margin including the PTVv and excluding the PTVd. The following doses were prescribed: 30 Gy (6 Gy/fraction) to PTVd, 37.5 Gy (7.5 Gy/fraction) to PTVt, and 45 Gy (9 Gy/fraction) to PTVv, respectively. Treatment was planned with an IMRT technique. RESULTS: The primary end-point (PTVv CONCLUSIONS: Although the PTVv