Incidence of Radiation Recall in A Community Cancer Center

e19640 Background: The incidence and severity of radiation complication recall is under reported, yet it is responsible for significant short and long term morbidity that can result in disabling consequences. Even prospective clinical trials often fail to address this issue since long term follow up is required to fully detect the signs and symptoms resulting from the late radiation recalls. This retrospective report details the incidence of radiation recall phenomenon in a community practice. Methods: A retrospective chart review of 334 patients using HER data relying on the diagnosis entered as radiation complications was done in one community medical oncology practice. The charts of the patients who developed significant radiation complications were reviewed for evidence of RC that was significant enough to require medical intervention. The site and number of RC events was analyzed. Results: Of the 334 charts reviewed, 139 patients were identified who developed a significant degree of radiation therapy complications. Nineteen patients (13%) developed one or more definite radiation recall. The sites of recall were as follows; 15 cases were RC complications in the chest including radiation pneumonitis, radiation esophagitis and one case of radiation carditis resulting in a picture similar to severe viral carditis causing severe congestive heart failure. Three cases had RC in the throat and one case of radiation proctitis recall. In most cases the RC was precipitated by intercurrent viral or bacterial infections. The total number of recall events was 42. Some patients developed more than one episode as follows; radiation pneumonitis 20, radiation cystitis 3, radiation proctitis 5 and radiation mastitis 7 episodes. In many patients recall affected more than one organ. Conclusions: radiation recall is a significant under reported source of morbidity in patients receiving radiation therapy for the treatment of cancer. The retrospective nature of this study probably underestimates the incidence of RC in cancer patients. Long term prospective studies are needed to fully understand the incidence and impact of this phenomenon.