3293 - Patient Demographic Factors Associated with Radiation Cystitis Development following Radiation for Prostate Cancer

Purpose/Objective(s): Chronic Radiation Cystitis (RC) may occur several months to years after completing pelvic malignancy radiotherapy. It manifests in hematuria and bothersome cystitis symptoms, often requiring unplanned healthcare interventions. Many prior studies evaluating RC are limited by sample size, short-term follow up, and homogeneous populations. Given the growing number of pelvic malignancy survivors, there is a need to understand the current RC rate and associated patient factors. The purpose of this study is to evaluate contemporary 5-year rates of RC development and associated patient demographic factors following radiation for prostate cancer.

Materials/Methods: A retrospective cohort study of adult male prostate cancer patients with a minimum of 5 years of follow up were identified in the Vizient database via ICD-9 and ICD-10 diagnosis codes. Using CPT and ICD codes, rates of RC after index radiation completion were identified. Patient demographic factors including age, sex, race, smoking history, ethnicity, insurance coverage, and socioeconomic status defined by neighborhood were collected. Multivariable logistic regression models to evaluate factors associated with RC development were used.

Results: Between 2014 and 2018, 143,567 adult men were identified who received prostate cancer radiation therapy. Approximately 98% (140,190/143,567) had localized, non-metastatic disease. More than 20% (30,415/143,567) developed RC a median of 23.6 months (Interquartile Range 9.1-38.4 months) following radiation treatment. Patient factors associated with RC included older age, metastatic disease, Black race, Asian race, Hispanic ethnicity, Medicare coverage, Medicaid insurance, and living in a more vulnerable neighborhood (Table 1).

Conclusion: In a large cohort of patients undergoing radiation treatment for mostly localized prostate cancer with at least 5 years follow up, we found greater than 20% developed RC. In this group, Black, Asian, and Hispanic race/ethnicity as well as residence in more vulnerable neighborhoods were associated with higher odds of developing RC. Further research is needed to better understand RC development and management.