Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.

Published: Thursday 12th December 2024
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in:

Open Access 01-12-2024 | Radiotherapy | Research

Use of antipsychotic drugs during radiotherapy in adult cancer patients in Korea: a nationwide retrospective cohort study based on the national health insurance service database

Authors: In Gyu Hwang, Song E Park, Sun Mi Kim, Dae Ryong Kang, Tae-Hwa Go, Se Hwa Hong, Yong-Chan Ha, Shin Young Park, Hyunho Lee, Jin Hwa Choi

Published in: Radiation Oncology | Issue 1/2024

Login to get access

Abstract

Background

Antipsychotic drugs (APDs) are used for treating mental illnesses and are also used by cancer patients. This study aimed to evaluate APD use in adult cancer patients who received radiotherapy (RT) in South Korea and assess the effects of APD use during RT on survival.

Methods

This retrospective cohort study utilized the National Health Insurance Service database database of Korea. We included adult cancer patients who underwent RT or chemotherapy (CTx, cisplatin, or 5-Fluorouracil) between 2010 and 2020. The APDs included in the analysis were aripiprazole, quetiapine, olanzapine, risperidone, haloperidol, and chlorpromazine.

Results

Overall, 725,897 patients received RT, and 115,500 received concomitant chemo-radiotherapy (CCRT). Of them, 41,118 (5.6%) took APDs during RT, and 8,129 (7%) took APDs during CCRT. Overall, 27,789 (67.58%) patients who took APDs during RT were men, and 28,004 (68.2%) were aged ≥ 60 years. The most frequently used APD during RT was quetiapine (64.93%). Patients who took APDs during RT and during CCRT had higher mortality rates (HR: 3.45 and 1.72, p < 0.0001, respectively) compared to the non-APD patients. Of the patients who used APDs during RT, patients accompanying psychiatric diagnosis, taking high-dose APD, and taking APD for more than 3 months had lower mortality than patients without psychiatric diagnosis, taking low-dose APD, and taking APD for less than 3 months, respectively (HR: 0.88, 0.87 and 0.80, respectively, p < 0.0001).

Conclusions

Only 5.6% of patients who underwent RT used APDs, and quetiapine was the most frequently prescribed APD during RT. The use of APD during RT may adversely affect survival. Further studies are required to elucidate the effects of APDs on cancer patients.

Trial registration

This study is retrospectively registered.
Appendix
Available only for authorised users
Literature
1.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer statistics 2020: GLOBOCAN estimates of incidence and Mortality Worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.CrossRefPubMed
2.
Mehta RD, Roth AJ. Psychiatric considerations in the oncology setting. CA Cancer J Clin. 2015;65(4):300–14.CrossRefPubMed
3.
Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, Meader N. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12(2):160–74.CrossRefPubMed
4.
5.
Fond G, Macgregor A, Attal J, Larue A, Brittner M, Ducasse D, Capdevielle D. Antipsychotic drugs: pro-cancer or anti-cancer? A systematic review. Med Hypotheses. 2012;79(1):38–42.CrossRefPubMed
6.
Dalton SO, Johansen C, Poulsen AH, Norgaard M, Sorensen HT, McLaughlin JK, Mortensen PB, Friis S. Cancer risk among users of neuroleptic medication: a population-based cohort study. Br J Cancer. 2006;95(7):934–9.CrossRefPubMedPubMedCentral
7.
Bhat K, Saki M, Cheng F, He L, Zhang L, Ioannidis A, Nathanson D, Tsang J, Bensinger SJ, Nghiemphu PL, et al. Dopamine receptor antagonists, Radiation, and Cholesterol Biosynthesis in mouse models of Glioblastoma. J Natl Cancer Inst. 2021;113(8):1094–104.CrossRefPubMedPubMedCentral
8.
Zhang X, Xu R, Zhang C, Xu Y, Han M, Huang B, Chen A, Qiu C, Thorsen F, Prestegarden L, et al. Trifluoperazine, a novel autophagy inhibitor, increases radiosensitivity in glioblastoma by impairing homologous recombination. J Exp Clin Cancer Res. 2017;36(1):118.CrossRefPubMedPubMedCentral
9.
Leucht S, Samara M, Heres S, Patel MX, Woods SW, Davis JM. Dose equivalents for second-generation antipsychotics: the minimum effective dose method. Schizophr Bull. 2014;40(2):314–26.CrossRefPubMedPubMedCentral
10.
Holland JC, Andersen B, Breitbart WS, Buchmann LO, Compas B, Deshields TL, Dudley MM, Fleishman S, Fulcher CD, Greenberg DB, et al. Distress management. J Natl Compr Canc Netw. 2013;11(2):190–209.CrossRefPubMed
11.
Lu D, Andersson TM, Fall K, Hultman CM, Czene K, Valdimarsdottir U, Fang F. Clinical diagnosis of Mental disorders immediately before and after Cancer diagnosis: a Nationwide Matched Cohort Study in Sweden. JAMA Oncol. 2016;2(9):1188–96.CrossRefPubMed
12.
Sanjida S, Janda M, Kissane D, Shaw J, Pearson SA, DiSipio T, Couper J. A systematic review and meta-analysis of prescribing practices of antidepressants in cancer patients. Psychooncology. 2016;25(9):1002–16.CrossRefPubMed
13.
14.
Singer S, Das-Munshi J, Brahler E. Prevalence of mental health conditions in cancer patients in acute care–a meta-analysis. Ann Oncol. 2010;21(5):925–30.CrossRefPubMed
15.
Ng CG, Boks MP, Smeets HM, Zainal NZ, de Wit NJ. Prescription patterns for psychotropic drugs in cancer patients; a large population study in the Netherlands. Psychooncology. 2013;22(4):762–7.CrossRefPubMed
16.
Miller KMM, editor. Oncology. 3rd ed. Washington, DC APPI; 2019.
17.
Fernandez-Robles CGGS, editor. Cancer: psychiatric care of the oncology patient. Washington, DC APPI; 2020.
18.
Bai L, Xu Z, Huang C, Sui Y, Guan X, Shi L. Psychotropic medication utilisation in adult cancer patients in China: a cross-sectional study based on national health insurance database. Lancet Reg Health West Pac. 2020;5:100060.PubMedPubMedCentral
19.
Shirama FH, Silva TB, Dos Santos JC, de Oliveira PA, de Oliveira JI, Borges TL, Miasso AI. Factors associated with common mental disorders and use of psychiatric drugs in cancer outpatients. Arch Psychiatr Nurs. 2019;33(5):88–93.CrossRefPubMed
20.
Kirkbride JB, Errazuriz A, Croudace TJ, Morgan C, Jackson D, Boydell J, Murray RM, Jones PB. Incidence of schizophrenia and other psychoses in England, 1950–2009: a systematic review and meta-analyses. PLoS ONE. 2012;7(3):e31660.CrossRefPubMedPubMedCentral
21.
Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911–22.CrossRefPubMed
22.
Kim E, Jang WI, Yang K, Kim MS, Yoo HJ, Paik EK, Kim H, Yoon J. Clinical utilization of radiation therapy in Korea between 2017 and 2019. Radiat Oncol J. 2022;40(4):251–9.CrossRefPubMedPubMedCentral
23.
Wootten JC, Wiener JC, Blanchette PS, Anderson KK. Cancer incidence and stage at diagnosis among people with psychotic disorders: systematic review and meta-analysis. Cancer Epidemiol. 2022;80:102233.CrossRefPubMed
24.
Vlachos N, Lampros M, Voulgaris S, Alexiou GA. Repurposing antipsychotics for Cancer Treatment. Biomedicines 2021, 9(12).
25.
Wikman A, Ljung R, Johar A, Hellstadius Y, Lagergren J, Lagergren P. Psychiatric morbidity and survival after surgery for esophageal cancer: a population-based cohort study. J Clin Oncol. 2015;33(5):448–54.CrossRefPubMed
26.
Choi J. Promoting Mental Health Literacy at schools in South Korea. Soa Chongsonyon Chongsin Uihak. 2023;34(1):15–20.PubMedPubMedCentral
27.
Markowitz JD, Narasimhan M. Delirium and antipsychotics: a systematic review of epidemiology and somatic treatment options. Psychiatry (Edgmont). 2008;5(10):29–36.PubMed
28.
El Majzoub I, Abunafeesa H, Cheaito R, Cheaito MA, Elsayem AF. Management of altered mental status and delirium in cancer patients. Ann Palliat Med. 2019;8(5):728–39.CrossRefPubMed
29.
Fang CK, Chen HW, Liu SI, Lin CJ, Tsai LY, Lai YL. Prevalence, detection and treatment of delirium in terminal cancer inpatients: a prospective survey. Jpn J Clin Oncol. 2008;38(1):56–63.CrossRefPubMed
Metadata
Title
Use of antipsychotic drugs during radiotherapy in adult cancer patients in Korea: a nationwide retrospective cohort study based on the national health insurance service database
Authors
In Gyu Hwang
Song E Park
Sun Mi Kim
Dae Ryong Kang
Tae-Hwa Go
Se Hwa Hong
Yong-Chan Ha
Shin Young Park
Hyunho Lee
Jin Hwa Choi
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2024
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-024-02558-8

Other articles of this Issue 1/2024

A retrospective study on the analysis of influencing factors of neutropenia in endometrial cancer with adjuvant chemoradiotherapy

Radio-opaque contrast agents for liver cancer targeting with KIM during radiation therapy (ROCK-RT): an observational feasibility study

Systematic review and pooled analysis of the impact of treatment-induced lymphopenia on survival of glioblastoma patients

Dose tracking assessment for magnetic resonance guided adaptive radiotherapy of rectal cancers

Advances in breast cancer treatment: a systematic review of preoperative stereotactic body radiotherapy (SBRT) for breast cancer

Functional imaging guided stereotactic ablative body radiotherapy (SABR) with focal dose escalation and bladder trigone sparing for intermediate and high-risk prostate cancer: study protocol for phase II safo trial