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Background: Women with breast cancer in northwest Syria, an area of protracted armed conflict, face multiple intersecting challenges to accessing care which may relate to gender, social structures, and financial constraints. Our aim was to explore the perspectives of women with breast cancer in northwest Syria about the impact of their diagnosis and experiences of accessing care., Methods: Women who accessed diagnosis or clinical care at the Syrian American Medical Society (SAMS) oncology centre in Idlib city during 2022 were identified from hospital records; they were invited to participate in semi-structured interviews conducted in Arabic by four local female-trained researchers. Participation was voluntary and informed consent was sought. Semi-structured interviews were conducted in August and September 2022 until thematic saturation was reached. Data were audio recorded and transcribed in Arabic before translation and thematic analysis using Nvivo to identify key emerging themes., Results: 22 women with breast cancer were interviewed. Findings were categorised into three themes: 1. Challenges to accessing oncology care in northwest Syria 2. Interactions with healthcare workers 3. The role of community and society. All participants noted the financial strains which the breast cancer diagnosis placed on them and their families. Most also noted the additional strains of travelling long distances, either in northwest Syria or to Turkey, where referral would entail additional costs, bureaucracy or isolation from family or social support. Some participants described social impacts including the expectation that they would continue with household chores and childcare even while ill. Patients reported that strong faith, having children, compassion from healthcare staff and peer support as being important factors for coping with their diagnosis and treatment., Conclusion: Though there have been improvements to breast cancer care in northwest Syria, stock-outs and the lack of availability of radiotherapy may still force women to travel to Turkey for further investigations or treatment. Our findings suggest increased support for women with breast cancer as well as their families is required. This work is a starting point for future research on this topic both in northwest Syria and other areas in Syria., Competing Interests: Declaration of competing interest The authors have declared that no competing interests exist., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: To improve the early detection of responders to salvage external beam radiotherapy (RT) after radical prostatectomy (RP)., Methods: Between 2002 and 2007, in a single institution, 136 consecutive patients received salvage RT to a dose of 66 Gy without androgen-deprivation therapy after RP for a rising prostate-specific antigen (PSA) level. PSA measurements were systematically performed before RT (PSART), at the fifth week of RT (PSA5), and in the follow-up at least twice a year (every 6 mo). The PSA level decline during RT was expressed as PSA ratio (PSA5/PSART). Two different definitions of biochemical failure after salvage RT were considered: PSA level>0.4 ng/ml and PSA>PSA nadir post-RT +0.4 ng/ml. Statistical analyses included univariate and multivariate Cox regression models., Results: The median follow-up was 60 months. The 5-year freedom from biochemical and clinical failure rates were 57% (95% CI: 48%-66%) and 92% (95% CI: 87%-97%), respectively. The mean PSA5 was 0.61 ng/ml (range: 0-7) and the mean PSA ratio was 0.67 (0-1.7). A PSA ratio<1 was a significant prognostic factor in multivariate analysis for both definitions of biochemical failure (P = 0.01 for both) and for clinical failure (P = 0.005)., Conclusions: For patients undergoing salvage RT after RP for a rising PSA level, the absence of PSA level decline during RT is predictive of biochemical and clinical failure and may be used to rapidly identify poor responders., (Copyright © 2015 Elsevier Inc. All rights reserved.)