1849P - Use of antipsychotic drugs during radiotherapy in adult cancer patients in Korea: The nationwide retrospective cohort study based on the health insurance review and assessment service database

Background

Antipsychotic drugs (APDs) are used in cancer patients for mental illness. There have been attempts to repurpose APD for cancer treatment based on suggestions that APD may have anti-cancer effects. However, reports on the use of APDs in cancer patients have been absent in Korea. Therefore, we conducted a nationwide study to assess the use of APDs during radiotherapy (RT) in adult cancer patients in South Korea.

Methods

We utilized the Health Insurance Review and Assessment Service database of all Koreans. We conducted an analysis on cancer patients identified by the International Classification of Diseases, aged ≥18, from 2010 to 2020, who underwent RT or chemotherapy (cisplatin or 5-Fluorouracil). Data including sex, age, diagnosis code, and prescription details of APDs were collected. The APDs included in the analysis were aripiprazole, quetiapine, olanzapine, risperidone, haloperidol, and chlorpromazine.

Results

A total of 558,318 patients received RT, and 100,810 patients received concomitant chemo-radiotherapy (CCRT). Among the patients who received RT, 78,785 were prescribed APD, and 19,689 (4%) took APD during RT. Among the patients who received CCRT, 21,689 were prescribed APD, and 4,612 (4.7%) took APD during CCRT. The number of patients who took ADP during RT was 3.598 (78.01%) in men. The age distribution was as follows: 0.67%, 2.23%, 8.54%, 23.87%, 34.35%, 26.24%, and 4.10% were in <30s, 40s, 50s, 60s, 70s, and ≥80, respectively. When classifying patients who took ADP during RT by diagnosis, lung cancer accounted for 18.53% (12,355 out of 66,669), and breast cancer accounted for 2.21% (2,896 out of 130,700). The most frequently used ADPs during RT were quetiapine (62.11%), chlorpromazine (14.21%), risperidone (12.64%), olanzapine (11.03%), aripiprazole (0.01%), and haloperidol (0.002%). Survival of patients prescribed APD during RT was worse compared to those without APD (HR 2.84).

Conclusions

Only 4% of patients who received RT took ADP simultaneously during RT and took quetiapine the most. The survival rate of patients who took ADP during RT was worse than those who did not. Further studies are needed on the effects of ADP in cancer patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.