Psychiatric comorbidity impact on radiotherapy and overall survival: a matched pair analysis.
Max Peters,
The Netherlands
PO-1571
Abstract
Psychiatric comorbidity impact on radiotherapy and overall survival: a matched pair analysis.
Authors: Max Peters1, Hajo Boersma1, Peter S.N. van Rossum1, Jasper van Oort2, Wiepke Cahn3, Joost J.C. Verhoeff1
1University Medical Center Utrecht, Radiation Oncology, Utrecht, The Netherlands; 2Radboud University Medical Center, Psychiatry, Nijmegen, The Netherlands; 3University Medical Center Utrecht Brain Center, Psychiatry, Utrecht, The Netherlands
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Purpose or Objective
The effect of a psychiatric disorder (PD) on the choice of radiotherapy regimens and subsequent cancer control outcomes is largely unknown. In this study, we evaluated differences in radiotherapy regimens and overall survival (OS) between cancer patients with a PD in comparison with a control population of patients without a PD.
Material and Methods
Referred patients with a PD (i.e. schizophrenia spectrum disorder, bipolar disorder, and borderline personality disorder) were included through a text-based search of the electronic patient database of all the patients that received radiotherapy between 2015-2019 at a single centre. Each patient was matched to a patient without a PD. Matching was based on cancer type, staging, performance score (WHO/KPS), non-radiotherapeutic cancer treatment, gender and age. Outcomes were the amount of fractions received, total dose, and OS.
Results
88 patients with PD were identified; 44 patients with schizophrenia spectrum disorder, 34 with bipolar disorder, and 10 with borderline personality disorder. Matched patients without a PD showed similar baseline characteristics. No statistically significant difference was observed regarding the number of fractions with a median of 16 (interquartile range [IQR] 3-23) versus 16 (IQR 3-25), respectively (p=0.47). Additionally, no difference in total dose was found. Kaplan Meier curves showed statistically significant differences in OS between the patients with a PD versus those without a PD, with 3-year OS rates of 47% versus 61%, respectively (hazard ratio [HR] 1.57, 95%-CI 1.05-2.35, p=0.03).
Conclusion
Cancer patients referred for radiotherapy with schizophrenia spectrum disorder, bipolar disorder, or borderline personality disorder receive similar radiotherapy schedules for a variety of tumour types but attain worse survival.