title: Correlation of radiation treatment interruptions with psychiatric disease and performance status in head and neck cancer patients.
abstract: OBJECTIVE
  The purpose of this study is to identify factors predictive of treatment interruptions during radiation therapy (RT) for head and neck cancer.
  
  
  METHODS
  The medical records of 280 consecutive patients who completed a 6- or 7-week course of RT for squamous cell carcinoma of the head and neck were reviewed. The number of missed treatment days, excluding those due to holidays or machine downtime, was determined for each patient. All patients were treated to a median dose of 63 Gy (range, 60 to 70 Gy).
  
  
  RESULTS
  The proportion of patients who missed 0, 3-5, 6-10, and greater than 10 days was 25, 59, 12, and 5 %, respectively. The percentage of patients who missed greater than 5 days was 62 % among the 39 patients with Karnofsky Performance Status (KPS) score of 70 or less compared to 10 % among those with a KPS score of greater than 70 (p < 0.01). Among the 33 patients identified with a preexisting psychiatric condition, the percentage that subsequently missed greater than 5 days of treatment was 48 % compared to 13 % among those without a psychiatric condition. When missed RT days were analyzed as a continuous variable, the correlations with both KPS and preexisting psychiatric condition remained highly significant (p < 0.01, for both).
  
  
  CONCLUSIONS
  Poor performance status and preexisting psychiatric condition predicted for treatment interruptions during RT for head and neck cancer. In view of the possible detrimental effect on treatment outcome, appropriate social programs should be initiated to overcome potential barriers to RT for these particular populations.
authors.affiliation: Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, 4501 X Street, Suite G140, Sacramento, CA, USA.
authors.forename: Radhika
authors.initials: R
authors.lastname: Sreeraman
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Vijayakumar
authors.forename: Allen M
authors.initials: AM
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000523:psychology* / Q000532:radiotherapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D001523:Mental Disorders / Q000503:physiopathology* / Q000523:psychology; D008875:Middle Aged; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
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