(P060) Impact of Major Psychiatric Disorders on Tolerance and Outcomes for Men With Prostate Cancer Undergoing Dose-Escalated Radiation Therapy

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OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

This study did not find any significant differences in treatment tolerance or any outcome endpoints between men with and without psychiatric disorders undergoing definitive radiation treatment for prostate cancer. This finding suggests that early diagnosis and reduced barriers to definitive treatment will alleviate the decreased cancer-specific mortality in this patient population.

Joseph Safdieh, MD, J. Rineer, MD, A. Wong, MD, D. Schwartz, MD, D. Schreiber; SUNY Downstate Medical Center; University of Florida Health Cancer Center at Orlando; Department of Veteran Affairs, NY Harbor Campus

PURPOSE/OBJECTIVES: Prior studies have revealed that patients with psychiatric disorders and prostate cancer have worse survival outcomes compared with the general population. However, many of these studies have associated these outcomes with delayed diagnosis and/or reduced access to definitive treatment. The purpose of this study was to investigate the toxicity and outcomes of patients with or without psychiatric disorders who were a primarily prostate-specific antigen (PSA)-screened population and who accepted definitive treatment with external beam radiation.

MATERIALS AND METHODS: The charts of 469 patients diagnosed with prostate cancer from 2003–2010 who were treated with external beam radiation (minimum dose 7,560 cGy) were reviewed. Patients were identified as having no psychiatric disorder (−Psy) or having a psychiatric disorder (+Psy) consisting of a Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV diagnosis of posttraumatic stress disorder, depression, schizophrenia, bipolar disorder, or generalized anxiety disorder. Kaplan-Meier analysis was used to analyze biochemical control, distant control, prostate cancer–specific survival, and overall survival (OS). Multivariate Cox regression was used to look for covariates associated with toxicity or biochemical control.

RESULTS: The charts of 469 patients were reviewed, and 100 patients (21.3%) were found to be +Psy. At a median follow-up of 73 months, there was no difference between the two groups regarding 6-year biochemical failure–free survival (79.8% −Psy vs 80.4% +Psy; P = .50) or 6-year distant metastatic-free survival (96.4% −Psy vs 98.0% +Psy; P = .36). There were also no differences regarding 6-year prostate cancer–specific survival (98.4% −Psy vs 99.0% +Psy; P = .45) or 6-year OS (80.2% −Psy vs 82.2% +Psy; P = .35). Likewise, short- and long-term genitourinary and gastrointestinal toxicities were similar between the groups. On multivariate analyses, the presence of +Psy was not a significant predictor for toxicity or biochemical recurrence.

CONCLUSIONS: This study did not find any significant differences in treatment tolerance or any outcome endpoints between men with and without psychiatric disorders undergoing definitive radiation treatment for prostate cancer. This finding suggests that early diagnosis and reduced barriers to definitive treatment will alleviate the decreased cancer-specific mortality in this patient population.

Proceedings of the 97th Annual Meeting of the American Radium Society- americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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