Dr Andriana Michaelidou MBBS BSc Inter MRCP FRCR MSc, Guys' & St Thomas' NHS Foundation Trust
18F-FDG-PET in guiding dose-painting with intensity modulated radiotherapy in oropharyngeal tumours: A phase I feasibility study (FiGaRO)
Locally advanced oropharyngeal cancer is treated with a combination of radiotherapy and chemotherapy. Radiotherapy works by using high energy x-rays to destroy cancer cells. Although many patients are cured by this treatment, not all of the cancer cells are destroyed and, in some, the cancer does come back.
Studies have suggested that more efficient killing of cancer cells, and therefore, better cure rates, can be achieved by increasing the radiotherapy dose. However, in the past, this was not possible due to side effects.
Intensity Modulated Radiotherapy (IMRT) is a relatively new technique that allows better shaping of the radiation dose. By using IMRT we can deliver an intentionally higher dose of radiation (boost) to small selected areas of tumour, whilst keeping doses to organs at risk within acceptable limits.
In this study we use 18F-FDG-PET (18F-fluorodeoxyglucose-positron emission tomography, also known as a ‘PET’ scan) to select areas of tumour that appear more active and may benefit form an IMRT boost. If we prove that this approach is well-tolerated, then we may be able to improve cure rates with this treatment. We will also establish a way of using 18F-FDG-PET in radiotherapy planning that can be used across different tumour sites.
Miss Aphrodite Iacovidou MBChB MSc MRCS (ENT) DOHNS, Imperial College NHS Trust
Study to evaluate the validity of the ThyroSeq V2 gene panel to reduce the need for diagnostic hemithyroidectomy in follicular lesions of the thyroid (Thy3F)
Approximately 15 per cent of the population have thyroid nodules – which are small lumps in the neck area that may be cancerous. Furthermore, half of women and 20 per cent of men over the age of 50 have thyroid nodules.
When these lumps are biopsied up to 15 per cent are identified as ‘suspicious lesions’ called Thy3f, and in most instances require diagnostic lobectomy. However, only 25 per cent of Thy3F lesions are diagnosed as cancer and therefore 75 per cent of patients undergo unnecessary surgery. This has implications both on healthcare resources and patient morbidity.
The University of Pittsburgh Medical Centre Division of Molecular and Genomic Pathology have developed ThyroSeq® next-generation sequencing in an attempt to improve detection of cancer in indeterminate cases of Thy3F lesions. ThyroSeq v.2 detects point mutations and gene fusions in more than 60 thyroid cancer genes.
Our aim is to validate this promising genetic assay and assess if it could improve detection of those with no mutations and prevent unnecessary operations, patient morbidity and healthcare cost.