Miguel Reis Ferreira

Guy's and St Thomas' NHS Foundation Trust · Department of Oncology

BACKGROUND IDH wildtype Glioblastoma multiforme (GBM) is an aggressive primary brain tumour. Despite treatment with surgical resection, radiotherapy (± chemotherapy) and adjuvant chemotherapy median survival remains poor. Antibiotics influence the human microbiota and alter treatment efficacy in other tumours. This study addresses antibiotic exposu...

Background The search for factors beyond the radiotherapy dose that could identify patients more at risk of developing radio-induced toxicity is essential to establish personalised treatment protocols for improving the quality-of-life of survivors. To investigate the role of the intestinal microbiota in the development of radiotherapy-induced gastr...

TPS6128 Background: Head and Neck Squamous Cell Carcinoma (HNSCC) is the 7 th most common cancer worldwide with more than 660,000 cases diagnosed annually. Many patients present with locally advanced disease, which despite aggressive multi-modality treatment remains associated with poor survival. Approximately 50% of patients relapse within 2 years...

Background and purpose: Peer review of head and neck cancer radiation therapy target volumes by radiologists was introduced in our center to optimize target volume delineation. Our aim was to assess the impact of MR imaging-based radiologist peer review of head and neck radiation therapy gross tumor and nodal volumes, through qualitative and quant...

Purpose/Objective(s) Patients undergoing curative (chemo)radiotherapy ((C)RT) for head and neck cancer (HNC) who experience or are at risk of developing dysphagia are often provided with pre-treatment swallow exercises (SE), in line with consensus opinion for best practice. Evidence of SE efficacy is limited, with adherence cited as a confounding f...

Purpose/Objective(s) As part of the introduction of planning MRI into the Radiotherapy (RT) workflow of Head Neck (HN) patients, we included HN radiology peer review to optimize target delineation. We hypothesized that this would result in significant target volume changes. Materials/Methods Radical cases with a fused diagnostic or RT planning MRI...

Purpose/Objective(s) Patient Reported Outcome Measures (PROMs) are validated questionnaires completed by patients to provide their perspective on their current state of health and quality of life (QoL). When used in clinical practice during radiotherapy (RT), PROMs can monitor adverse events allowing the early identification of patients who are str...

PEARLS is a multi-stage randomised controlled trial for prostate cancer patients with pelvic and/or para-aortic PSMA-avid lymph node disease at presentation. The aim of the trial is to determine whether extending the radiotherapy field to cover the para-aortic lymph nodes (up to L1/L2 vertebral interspace) can improve outcomes for this patient grou...

Radiotherapy is a linchpin in head and neck squamous cell carcinoma (HN-SCC) treatment. Modulating tumour and/or normal tissue biology offers opportunities to further develop HN-SCC radiotherapy. The microbiota, which can exhibit homeostatic properties and be a modulator of immunity, has recently received considerable interest from the Oncology com...

TPS199 Background: Optimal management for lymph node (LN) positive prostate cancer has not yet been determined. With the emerging role of PSMA-PET/CT in diagnostic staging, identification of this disease status is increasing. The superior border for prostate nodal radiotherapy is variable across different centres. PEARLS (CRUK/19/016) aims to show...

Background 5-8% of the general population carry DPYD polymorphisms, risking severe toxicity from fluoropyrimidine (FP)-based chemotherapy at standard doses. In November 2018, Guy’s and St Thomas’ Hospital established a regional protocol mandating DPYD screening for all patients starting FP-based therapy. 5 common variants associated with FP toxicit...

Background Radiotherapy to the prostate and pelvic lymph nodes (PLNRT) is part of the curative treatment of high-risk prostate cancer (PCa). Yet, the broader influence of radiotherapy on patient physiology is poorly understood. We conducted comprehensive global metabolomic profiling of urine, plasma and stools sampled from patients undergoing PLNRT...

Objectives: To report clinical outcomes of relapsed oropharyngeal squamous cell carcinoma (OPSCC) after definitive intensity-modulated (chemo)radiotherapy [(C)RT]. Materials and methods: Data for all relapsed patients treated for OPSCC with definitive (C)RT between 2010-2016 was collected. Primary end-point was post-failure survival (PFS). Resu...

Purpose: To assess TNM 8 staging in discriminating overall survival (OS) amongst patients with locally advanced oral cavity squamous cell carcinoma (OCSCC) treated with surgery and post-operative radiotherapy (PORT), compared to TNM 7. Material and methods: Data from OCSCC patients treated with surgery and PORT between January 2010 and December...

Nivolumab is an anti-PD-1 monoclonal antibody currently used as immunotherapy for patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) with evidence of disease progression after platinum-based chemotherapy. This study evaluates real-world safety and treatment outcomes of non-trial nivolumab use. A retrospective multicent...

Colorectal cancer; sidedness; anti-EGFR

Purpose: Radiotherapy is important in managing pelvic cancers. However, radiation enteropathy may occur and can be dose limiting. The gut microbiota may contribute to the pathogenesis of radiation enteropathy. We hypothesized that the microbiome differs between patients with and without radiation enteropathy.Experimental Design: Three cohorts of p...

Background The majority of patients with human papillomavirus (HPV)‐associated oropharyngeal squamous cell carcinoma (OpSCC) have favourable survival outcomes, but a significant minority of individuals will die of their disease. There are currently no definitive criteria to identify HPV‐associated OpSCC patients with poor outcome. Recent reports su...

Aims: Pelvic lymph node (PLN) radiotherapy for high-risk prostate cancer is limited by late gastrointestinal toxicity. Application of rectal and bowel constraints may reduce risks of side-effects. We evaluated associations between intensity-modulated radiotherapy (IMRT) dose-volume data and long-term gastrointestinal toxicity. Materials and metho...

Purpose: To investigate the feasibility of dose escalation and hypofractionation of pelvic lymph node intensity modulated radiation therapy (PLN-IMRT) in prostate cancer (PCa). Methods and materials: In a phase 1/2 study, patients with advanced localized PCa were sequentially treated with 70 to 74 Gy to the prostate and dose-escalating PLN-IMRT...

To report the experience and the outcomes of interstitial high-dose-rate (HDR) brachytherapy (BT) of eyelid skin cancer at the Department of Radiotherapy of Hospital de Santa Maria in Lisbon. Seventeen patients (pts; mean age, 73.75 years) who underwent eyelid interstitial HDR BT with an (192)Ir source between January 2011 and February 2013 were an...

New gastrointestinal symptoms are frequent after pelvic radiotherapy and can greatly affect the quality of life of cancer survivors. The effect of radiation on the intestinal microbiota, and the clinical implications of a modified microbial balance after radiotherapy are now beginning to emerge. In this Personal View, we show the importance of the...

Carcinoma of the uterine cervix is the second most common cancer and the third leading cause of cancer death among women. For some decades combination of external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT) has become a Radiotherapy stand-ard treatment modality for cervix cancer. The purpose of this study is to assess dosimetry...

Background: Stevens Johnson Syndrome and Erythema Multiforme are hypersensitivity skin reactions generally arising in the context of multiple causes. Radiation therapy is considered to be one of these causes, although most reports are hindered by concomitant medications. Aim: The aim of this paper was to present a case of Stevens Johnson Syndrom...