PS1-18: Development and Characterization of a Cohort for Determining Long Term Secondary Side Effects Due to Radiation Treatment for Prostate Cancer Using an Electronic Health Record

摘要

Background/AimsThe long term secondary side effects from radiation treatment for prostate cancer are well described. Here we characterize a cohort with radiation treatment for prostate cancer and an electronic medical record. A subset of individuals, were selected for EPIC quality of life surveys. MethodsInclusion Criteria: Individuals must have radiation treatment for prostate cancer between 1993 and 2011 with medical care prior to treatment; after treatment there must be continued care within the Marshfield Clinic system. Chart Review: Electronic retrospective chart review was performed to determine the cohort characteristics, including age at diagnosis, stage and grade of cancer, radiation treatment type, diagnoses and medications and procedures indicative of gastrointestinal complications or urinary complications or sexual dysfunction (both pre and post treatment). Selection for Surveys: Individuals who were either enrolled in PMRP at the time of review or agreed to enrollment in PMRP when contacted received EPIC and (RAND SF-36 Health Survey) surveys. Resultsto date: Our cohort included 834 individuals (201 in PMRP). Average age at diagnosis was 70 (range 47-87), with an average interval between diagnosis and treatment of 117 days. Radiation treatments included brachytherapy 36% (302/834), EBRT (including IMRT) 47% (395/834), and combination treatment (16% (137/834). A majority (56% (469/834)) had at least one diagnosis of urinary, sexual or fecal complications prior to treatment, with 58% or 272/469 reporting sexual dysfunction. Long term side effects 90+ days after treatment were reported in the EHR for 64% (531/834), and 37% (309/834) experienced a potential RTOG Grade 2 or 3 event. Sexual dysfunction represented the largest diagnosis group (250 of 309). Diagnosis for urinary with complications were present in 33% of the brachytherapy patients (146/439) and 21% of those treated external beam radiation (84/395). Fecal complications were present in 23% (104/439) of the brachytherapy patients, and 30% (119/395) of those with EBRT treatment. DiscussionWe can use the EHR to identify individuals with long term clinically significant side effects. These individuals can be used in the future to develop models that identify pre-diagnosis health events that predict potential long term side effects from radiation treatment.