Background Access to cancer care is a problem that continues to plague refugees displaced from their home countries. The turbulent political crisis in Syria, which has led to millions of refugees seeking asylum in Turkey, merits further attention. We aimed to study the rate of utilization of radiation therapy among Syrian refugees with cancer living in Turkey in an attempt to identify the contributing factors predictive of non-compliance with prescribed RT. Methods In this retrospective review of 14 institutional databases, Syrian refugee patients in Turkey with a cancer diagnosis from January 2015 to December 2019 who were treated with RT were identified. The demographic data, treatment compliance rates, and toxicity outcomes in these patients were surveyed. Variable predictors of noncompliance such as age, sex, diagnosis, treatment length, and toxicity were studied. The association between these variables and patient noncompliance was determined. Results We identified 10,537 patients who were diagnosed with cancer during the study period, of whom 1010 (9.6%) patients were treated with RT. Breast cancer (30%) and lung cancer (14%) were the most common diagnoses with up to 68% of patients diagnosed at an advanced stage (Stage III, IV). 20% of the patients were deemed noncompliant. Treatment with concurrent chemoradiotherapy (OR 1.61, 95% CI 1.06–2.46, p = 0.023) and living in a refugee camp (OR 3.62, 95% CI 2.43–5.19, p < 0.001) were associated with noncompliance. Age, sex and treatment length were not significantly associated with noncompliance. Conclusions Noncompliance with radiotherapy among Syrian refugees in Turkey remains an area of concern with a multitude of factors contributing to these alarming numbers. Further studies to better ascertain the finer nuances of this intricately complex problem and a global combination of efforts can pave the way to providing a solution.

Malignant pleural mesothelioma (MPM) is a rare disease with a poor prognosis. The main therapeutic options for MPM include surgery, chemotherapy, and radiation therapy (RT). Although multimodality therapy has been reported to improve survival, not every medically operable patient is able to undergo all recommended therapy. With improvements in surgical techniques and systemic therapies, as well as advancements in RT, there has been a potential new paradigm in the management of this disease. In this review, we discuss the current literature on MPM management and propose a functional treatment algorithm.

PurposeTo report the utilization of radiation therapy in Syrian refugee patients with prostate cancer residing in Turkey.Methods and materialsA multi-institutional retrospective review including 14 cancer centers in Turkey was conducted to include 137 Syrian refugee patients with prostate cancer treated with radiation therapy (RT). Toxicity data was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Noncompliance was defined as a patient missing two or more scheduled RT appointments.ResultsAdvanced disease, defined as stage III or IV, was reported in 64.2% of patients while androgen deprivation therapy (ADT) was only administrated to 20% of patients. Conventionally fractionated RT with a median number of 44 fractions was delivered to all patients with curative intent (n = 61) while palliative RT (n = 76) was delivered with a median number of 10 fractions. The acute grade 3–4 toxicity rate for the entire cohort was 16%. Noncompliance rate was 42%.ConclusionMost Syrian refugee prostate cancer patients presented with advanced disease however ADT was seldom used. Despite the low treatment compliance rate, conventional fractionation was used in all patients. Interventions are critically needed to improve screening and increase the use of standard-of-care treatment paradigms, including hypofractionated RT and ADT.

BackgroundAccess to cancer care is a problem that continues to plague refugees displaced from their home countries. The turbulent political crisis in Syria, which has led to millions of refugees seeking asylum in Turkey, merits further attention. We aimed to study the rate of utilization of radiation therapy among Syrian refugees with cancer living in Turkey in an attempt to identify the contributing factors predictive of non-compliance with prescribed RT.MethodsIn this retrospective review of 14 institutional databases, Syrian refugee patients in Turkey with a cancer diagnosis from January 2015 to December 2018 who were treated with RT were identified. The demographic data, treatment compliance rates, and toxicity outcomes in these patients were surveyed. Variable predictors of noncompliance such as age, gender, diagnosis, geographic location, treatment length, and toxicity were studied. The association between these variables and patient noncompliance was determined.ResultsWe identified 10,537 patients who were diagnosed with cancer during the study period, of whom 1010 (9.6%) patients were treated with RT. Breast cancer (30%) and lung cancer (14%) were the most common diagnoses with up to 68% of patients diagnosed at an advanced stage (Stage III, IV). 20% of the patients were deemed noncompliant. Treatment with concurrent chemoradiotherapy (OR 1.61, 95% CI 1.06 – 2.46, p = 0.023) and living in a refugee camp (OR 3.62, 95% CI 2.43 – 5.19, p < 0.001) were associated with noncompliance. Age, gender and treatment length were not significantly associated with noncompliance.ConclusionsNoncompliance with radiotherapy among Syrian refugees in Turkey remains an area of concern with a multitude of factors contributing to these alarming numbers. Further studies to better ascertain the finer nuances of this intricately complex problem and a global combination of efforts can pave the way to providing a solution.

The aim of the present study was to evaluate the efficacy and safety of preoperative hypofractionated chemoradiotherapy in our patients with locally advanced rectum cancer, which was previously observed in the Far East (KROG 11-02). METHODSTwenty-seven patients with locally advanced rectal cancer (cT3-4N0-2M0) between November 2014 and August 2016 were included in the study. A 2-week schedule of hypofractionated radiotherapy, 33 Gy/10 fractions, with concurrent 1 cycle of oral capecitabine (1650 mg/m2/day) was applied. Patients were planned to undergo surgery 6-8 weeks after the completion of chemoradiotherapy. End points were tumor responses and toxicity. RESULTSAll patients underwent total mesorectal excision except for only 1 patient, and statistical analysis was performed on 26 patients. Of the 27 patients, 10 (38.4%) were downstaged, and 3 (11.5%) had a pathologically complete response. No grade 3-4 toxicity was observed in the patient group. Grade 1-2 hematologic toxicity developed in 2 (8%) patients, and no biochemical abnormality was observed. Gastrointestinal toxicity was observed in 17 (65%), genitourinary toxicity in 8 (30%), and radiodermatitis in 3 (11%) patients. One patient had permanent anastomosis and wound dehiscence, and presacral abscess was also seen in one patient. Enterocutaneous fistula developed in only one patient. CONCLUSIONA 2-week schedule of radiotherapy with oral capecitabine in patients with locally advanced rectal cancer resulted in similar toxicity levels and tumor response rate in comparison with previous results.