2875 - Assessment of Sleep as an Individual Toxicity of Radiotherapy

V. Rao¹, B. Zade¹, S. Singh¹, N. Dhawale¹, and A. Sharma²; ¹Ruby Hall Clinic, Pune, India, ²Freelance Statistician, Gurugram, India

Purpose/Objective(s): Sleep disorders during radiotherapy (RT) are attributed to other toxicities of treatment such as mucositis, dyspnea, and genitourinary or gastrointestinal symptoms. While these adverse events do affect sleep, radical treatment on its own may change somnolence patterns that are not commonly assessed, making sleep an overlooked side effect. We look to assess the patterns of sleep disorders in patients undergoing radical RT. Materials/

Methods: A cross-sectional analysis of all pelvic and head and neck (H&N) malignancy patients receiving RT across two institutions was conducted. Patients were asked to fill out the Pittsburgh Sleep Quality Index (PSQI). Additional questions about age, gender, site of malignancy, number of fractions, surgery, and concurrent chemotherapy+dexamethansone (CT+D) were included. PSQI scores were divided into 2 groups - <10 and >10. Fisher’s exact test was used to compare patients with or without sleep disturbances in all the additional parameters.
Results: 123 patients were included. 84 patients had H&N malignancies and 39 patients had pelvic cancers. 118 patients (95.9%) had a PSQI score >5 indicating the presence of sleep disorders. None of the patients were prescribed any medications to help them sleep. The following table shows Fishers exact test results of all the studied parameters. Patients who had received >3 weeks of RT had worse sleep disturbances than those who had <3 weeks of RT, and it did not correlate with the toxicity grading. H&N cancers were associated with a better score in the postoperative setting, and within 3 weeks of receiving RT. Stress among patients was not associated with sleep disturbances (n=50% vs 50%, p=0.2). All other parameters studied were not associated with a statistically significant worse sleep quality.
Conclusion: The high incidence of sleep disorders independent of other toxicities warrants the need to assess it as a separate toxicity. H&N cancer patients receiving postoperative RT, and all patients who have received >3 weeks of RT require additional interventions to alleviate this symptom.

Abstract 2875 – Table 1

H&N Cancer	Pelvic Cancers	All cancers
Male: 46%, Female: 45%, p=1	Male: 16%, Female: 44%, p=0.15	Male: 41%, Female: 45%, p=0.7
Age <50: 40%, >50: 51%, p=0.4	Age <50: 50%, >50: 31%, p=0.4	Age <50: 42%, >50: 45%, p=0.8
With CT+D: 50%, Without CT+D: 40%, p=0.5	With CT+D: 44%, Without CT+D: 21%, p=0.1	With CT+D: 48%, Without CT+D: 35%, p=0.1
With surgery: 35%, Without surgery: 58%, p=0.04	With surgery: 20%, Without surgery: 40%, p=0.4	With surgery: 33%, Without surgery: 50%, p=0.1
<3 weeks of RT: 39%, >3 weeks of RT: 64%, p=0.04	<3 weeks of RT: 25%, >3 weeks of RT: 47%, p=0.1	<3 weeks of RT: 36%, >3 weeks of RT: 57%, p=0.0003