Iain Phillips

Western General Hospital | SCAN · Edinburgh Cancer Centre

Lung cancer is the commonest malignancy worldwide and the leading cause of cancer death. Half of patients with lung cancer present with advanced disease. The number of systemic therapies including immunotherapy and targeted treatment are rapidly increasing. Despite this, the outcomes for many patients with locally advanced and advanced lung cancer...

Introduction Pembrolizumab is an established first-line option for patients with advanced non-small-cell lung cancer (NSCLC) expressing programmed death-ligand 1 ≥50%. Durable responses are seen in a subset of patients; however, many derive little clinical benefit. Biomarkers of the systemic inflammatory response predict survival in NSCLC. We evalu...

Objectives The Dietetic Assessment and Intervention in Lung Cancer (DAIL) study was an observational cohort study. It triaged the need for dietetic input in patients with lung cancer, using questionnaires with 137 responses. This substudy tested if machine learning could predict need to see a dietitian (NTSD) using 5 or 10 measures. Methods 76 cas...

Introduction: Despite significant advances in systemic anticancer therapy (SACT) for non-small cell lung cancer (NSCLC), many patients still fail to respond to treatment or develop treatment resistance. Albumin, a biomarker of systemic inflammation and malnutrition, predicts survival in many cancers. We evaluated the prognostic significance of albu...

Background: Prehabilitation is the practice of enhancing a patient's functional and psychological capacity before treatment commences. It is of interest in the cancer context because of the impact of treatments on quality of life and cancer survivorship. This work aims to document current practice, barriers and challenges to implementing prehabili...

Introduction European Society for Clinical Nutrition and Metabolism guidelines recommend that patients with cancer should be screened for malnutrition at diagnosis. The dietetic assessment and intervention in lung cancer study investigated the nutritional status of patients with non-small cell lung cancer (NSCLC) and the need for dietetic intervent...

Purpose of review: Outcomes for patients with advanced lung cancer have traditionally been very poor. This patient group are often comorbid, less fit and experience multiple symptoms. This review discusses strategies for minimizing the impact of cachexia on patients with advanced lung cancer. This is timely, as in recent years there has been a rapi...

TOURIST: Thoracic Umbrella Radiotherapy study in stage IV NSCLC: A phase III randomised trial in development Woolf D, Lee C, Shah R, Ahned M, Fraser I, BIllinghamL, Philips I, McAleese J, Hiley C, Taylor A, Calman L, Barton R, Hatton M. Background Non Small Cell Lung Cancer (NSCLC) is the leading cause of cancer mortality throughout the world wi...

Objective This study tested the hypothesis that shows advanced image analysis can differentiate fit and unfit patients for radical radiotherapy from standard radiotherapy planning imaging, when compared to formal lung function tests, FEV1 (forced expiratory volume in 1 s) and TLCO (transfer factor of carbon monoxide). Methods An apical region of i...

Purpose of review: Systemic therapy for lung cancer is increasing in intensity and duration. European nutrition guidelines suggest screening for weight loss and malnutrition, however acknowledges there is a lack of evidence. We discuss current data round this issue and identify opportunities for further research. Recent findings: International g...

Aims: Stereotactic ablative body radiotherapy (SABR) is now considered the standard of care for medically inoperable stage I non-small cell lung cancer (NSCLC). The English National Cancer Registration and Analysis Service (NCRAS) collects data on all patients diagnosed with lung cancer, including information on treatment. We wanted to compare out...

This paper studies the sensitivity of a range of image texture parameters used in radiomics to: i) the number of intensity levels, ii) the method of quantisation to select the intensity levels and iii) the use of an intensity threshold. 43 commonly used texture features were studied for the gross target volume outlined on the CT component of PET/CT...

Abstract Background Radiological sarcopenia (muscles loss) is a biomarker for poor outcome in many common cancers. The aim of this study was to establish if radiological sarcopenia at the time of diagnosis was a biomarker for overall survival or potential weight loss in patients with advanced lung cancer, who were reviewed by a dietitian later duri...

Lung cancer is the leading cause of cancer mortality worldwide. Treatment pathways include regular cross-sectional imaging, generating large data sets which present intriguing possibilities for exploitation beyond standard visual interpretation. This additional data mining has been termed 'radiomics' and includes semantic and agnostic approaches. T...

Background: One-third of new early breast cancer diagnoses occur in women over 70 years old. However, older women are less likely to receive radical curative treatments. This study prospectively evaluated a cohort of older women using a Comprehensive Geriatric Assessment (CGA) to determine whether fitness explained the apparent under-treatment in...

Aims: A normal tissue complication probability (NTCP) model of severe acute mucositis would be highly useful to guide clinical decision making and inform radiotherapy planning. We aimed to improve upon our previous model by using a novel oral mucosal surface organ at risk (OAR) in place of an oral cavity OAR. Materials and methods: Predictive model...

Introduction As a designated Commissioning Through Evaluation (CTE) Stereotactic Ablative Body Radiotherapy (SABR) centre, we evaluated the service given to patients who have received SABR for primary lung cancer or to oligometastases within CTE. Methods We surveyed a random sample of patients who received their treatment under the care of 1 consul...

Background and purpose: Current oral mucositis normal tissue complication probability models, based on the dose distribution to the oral cavity volume, have suboptimal predictive power. Improving the delineation of the oral mucosa is likely to improve these models, but is resource intensive. We developed and evaluated fully-automated atlas-based s...

Introduction: More than a third of breast cancer diagnoses are made in women aged 70 years or older at the time of diagnosis. Epidemiological studies and practice surveys from the US and Europe have demonstrated lower rates of use of adjuvant chemotherapy and radiotherapy in older women with early breast cancer. It is not clear whether this is due...

http://conference.ncri.org.uk/abstracts/2014/abstracts/B317.html

Androgen deprivation therapy (ADT) resulting in testosterone suppression is central to the management of prostate cancer (PC). As PC incidence increases, ADT is more frequently prescribed, and for longer periods of time as survival improves. Initial approaches to ADT included orchiectomy or oral estrogen (diethylstilbestrol [DES]). DES reduces PC-s...

Aims 1. To identify the incidence of CLM appropriate for conversion therapy in a cohort unbiased by outside referral 2. To assess rate of conversion from inoperable to operable CLM and how many patients progressed to liver surgery. Introduction • Operable colorectal liver only metastases (CLM) is a potentially curable condition. • Five year surviva...