No abstract

Failure to comply with treatment recommendations is very common in patients, but still poorly recognised by doctors. The current practice of using oral therapy on a large scale has been increasingly adopted for cancer patients. Chronic myeloid leukaemia (CML) is just such an example, where the introduction of taking new oral medications, the tyrosine kinase BCR-ABL inhibitors (TKI), has now revolutionised the treatment. The aim of our study was to assess treatment adherence in a group of Polish CML patients (a survey was conducted on 140 patient aged ≥18 years) treated with oral TKI (imatinib, dasatinib and nilotinib) taking into account the following variables: gender, age, education, place of residence, family circumstances and duration of therapy. In addition, we evaluated whether there is a relationship between how patients perceive their level of adherence to treatment recommendations with how subjectively the required dosage regimen was followed. Half the patients admitted to skipping at least one drug dose during the entire course of treatment and 39% did so within their last treatment month. Patients were also found to overestimate their own adherence assessment; around 60% of those missing at least 1 drug dose within the last treatment month believed they ‘always’ followed recommendations. The study demonstrated that adherence deteriorates over time. Furthermore, patients aged >65 years and patients suffering at least one comorbid disease had better adherence (p < 0.011). There were no differences in adherence among patients treated with imatinib, dasatinib and nilotinib (p = 0.249).

Hailey-Hailey disease, or familial benign chronic pemphigus, is an autosomal dominant genodermatosis. Disease symptoms may contribute to an adverse impact on quality of life and functional limitation and disability. As Hailey-Hailey disease is chronic and frequently recalcitrant to treatment, multiple therapeutic approaches, including surgical options, have been attempted. We describe here three cases of recalcitrant Hailey-Hailey disease that showed long-term improvement with radiotherapy. Axillary lesions were treated with electron beam at an anti-inflammatory dose (energy 6-8 MeV). Patients received 20 Gy in 10 fractions to 90% isodose, at each axilla. No disease recurrence was observed during a 38 months follow-up of the treated sites. The effect of radiotherapy was thus considered to be locally beneficial, but without any positive influence on the general course of the disease.

No abstract

Objectives: Prognosis in patients with locally advanced stomach cancer undergoing surgery alone is poor. High local failure rates in gastric cancer have been reported of up to 70%. When a relapse occurs, attempts at curative treatment are generally unsuccessful. A retrospective analysis was performed in order to determine whether post-operative radiochemotherapy improves treatment results in patients with locally advanced gastric cancer. . Overall survival and disease-free survival, as well as toxicity, were estimated for all patients. Results: Within the study group there were 7 (13%) local recurrences, 4 (7%) distant metastases and 8 (14%) local and distant relapses. The 2 year overall survival was 48%. A total of 19 (34%) patients developed Grade 3 gastrointestinal toxicity. There were no treatment-related deaths. Conclusion: Post-operative radiochemotherapy is an effective and safe regimen in patients with curatively resected locally advanced gastric cancer. Surgery remains the main treatment for stomach cancer; however, prognosis in patients with locally advanced stomach cancer who undergo surgery alone is poor. The 5 year survival rates in resected-only gastric cancer patients are 90% for clinical Stage I, 60% for Stage II, 33% for Stage III and ,5% for Stage IV [1]. Clinical stage, age, histological differentiation, depth of invasion, lymph node metastases and proximal third site of origin have been identified as the independent prognostic factors [1,2]. Local relapse in the tumour bed and regional lymph node or distant metastases are the cause of relapse after curative resection. Extension of surgical procedures, including splenectomy, omentectomy and radical lymph node dissection, have not been shown to improve survival or to decrease the rate of locoregional failure [3]. For patients with high risk, clinically advanced Stage IB-IV with M0 gastric cancer, there is undoubtedly a need for effective adjuvant treatment following surgery. The results of Phase III randomised trials of adjuvant chemotherapy after resection in gastric cancer are inconsistent; most studies of post-operative chemotherapy did not show a significant improvement in overall survival [4][5][6][7][8]. The results of three published meta-analyses suggest that adjuvant chemotherapy after curative resection for gastric cancer might produce a small or borderline statistically significant improvement in overall survival [9][10][11]. Moreover, the results of randomised trials with radiotherapy as the sole treatment with curative gastric cancer resection also differ. In a British trial, adjuvant radiotherapy following surgery reduced locoregional failures, but no survival benefits were found [12]. By contrast, the results of a Chinese study showed a survival benefit for patients treated with pre-operative radiotherapy compared with surgery alone. In addition, locoregional failures were reduced in the arm of the study with pre-operative irradiation. The above-noted differences from the Chinese study were statistically significant [13]. Finally...