The burden of radiation therapy to the bone in patients with prostate cancer and bone metastases.

Abstract

e16512 Background: Bone metastases (mets) occur in up to 80% of patients (pts) with advanced prostate cancer and are associated with considerable skeletal morbidity. Radiation therapy is often used to treat spinal cord compression, pathologic fractures, and pain associated with bone mets. However, the burden of radiation therapy, such as dosing, number of fractions, exposure period, and frequency has not been well described. We present the treatment patterns of radiation episodes of care (REOCs) in pts with bone mets secondary to prostate cancer. Methods: Claims-linked medical records at 98 US cancer centers in 16 states were analyzed. Key inclusion criteria included a diagnosis of prostate cancer and bone mets; ≥1 visit to a radiation center on or after bone met diagnosis date (study period: 1 Jul 2008 to 31 Dec 2009); and radiation therapy to ≥1 bone site. Pts with unknown age or REOCs including non-bone site radiation were excluded. Visits and procedures were stratified into radiation and radiation-related categories. Results: A total of 233 REOCs in 213 pts were analyzed. The mean (SD) age was 74 (8.4) years and the mean (SD) Charlson Comorbidity index was 6 (1.1). The mean (SD) number of visits for a REOC was 13 (5.8), over a mean (SD) of 30 (16.7) days (from planning visit to follow-up). 71.7% of REOC visits involved radiation therapy, with the remaining visits for radiation-related procedures (table). The mean (SD) number of fractions per REOC was 10 (4). Conclusions: Radiation to the bone is a well recognized treatment for management of bone mets. The use of multi-fraction schedules is common and is associated with substantial burden to pts and healthcare providers. [Table: see text]