Aim:To evaluate two cases of gemcitabine-induced radiation recall in patients who were treated for localized pancreatic cancer, and review the literature. Methods: The two cases of radiation recall (from a cohort of 80 patients treated for pancreatic carcinoma) were retrospectively identified using patient medical records. Prior publications were identified through an English language literature search of MEDLINE Ovid from January 1966 to October 2006, using the key words gemcitabine and radiation recall. Results: Both the radiation recall reactions were limited to the gastrointestinal system, localized to previous radiotherapy field. No pathology was identified on radiological investigation. The onset of the radiation recall phenomenon was 2 and 10 days, respectively, from the time gemcitabine was initiated. The treatment of radiation recall consisted of the cessation of gemcitabine, initiating steroid therapy and supportive therapy. Both of the patients' symptoms achieved complete resolution. A comprehensive review of the literature found 15 previous cases of radiation recall related to gemcitabine but one reported effect involving the gastrointestinal system. Previously reported sites of recall phenomena included the skin, muscles, brain stem and optic nerve. In the treatment of pancreatic carcinomas, there were only four reported cases, three involving the onset of myositis of abdominal muscle and one case of gastrointestinal bleeding. Conclusion: Radiation recall from gemcitabine chemotherapy is uncommon. It can potentially arise in any site that has been irradiated previously. The treating doctor needs to be aware of this phenomenon to be able to manage this condition appropriately.

Head and neck cancer patients require oral assessment and management prior, during and after cancer treatment to minimise oral complications. Hence, this study aimed to evaluate sociodemographic data, oral health management, oral complications derived from cancer treatment, time frame in completing dental treatment and association between oral management and complications. Purposive record sampling of head and neck cancer patients who completed radiotherapy and/or chemotherapy at Hospital Universiti Sains Malaysia (HUSM) from 2011 to 2017 were reviewed. A checklist was used to record the data and analysed using descriptive statistics and Pearson Chi-square test. A number of 194 patient records were reviewed with majority were Malays (88.1%), males (61.3%) with the mean age of 57.18 years old. Only 21% of the patients had oral assessment prior to cancer treatment. About 84% of the referred patients were dentally fit within 1 month. Mucositis and fungal infections were the most prevalent complications. The relationship between oral assessment prior to cancer treatment and oral complications was not significant (p = 0.134). Despite the insignificant association due to several limitations, oral assessment and management prior, during and after cancer therapy are recognised as crucial for improving quality of life. A standard institutional operating procedure is recommended to improve patient care.