S566 I. J. Radiation Oncology d Biology d Physics Volume 78, Number 3, Supplement, 2010

(N = 3,087) external beam RT followed by a brachytherapy boost with (N = 2,723) or without (N = 986) a median duration of 4.2 (IQR3.3 - 5.5) months of neoadjuvant HT between 1991 and 2006. 70% of men had unfavorable-risk disease (Gleason score 7 or above;PSA 10 ng/mL or above; or clinical stage T2b or above). A Cox regression multivariable analysis was performed assessing whetherWP as compared to PORT affected the risk of ACM, adjusting for age, cardiovascular comorbidity, HT use, year of treatment, andknown PC prognostic factors. A formal test for interaction between the radiation treatment volume and HT use was performed.

Results: After a median follow-up of 3.3 years, there were a total of 561 deaths. Within the interaction model, the use of WPRT ascompared to PORT was significantly associated with a decreased risk of ACM (adjusted hazard ratio [AHR] 0.58, 95% confidenceinterval [CI], 0.38 - 0.89, p = 0.01). Similarly, HT use was significantly associated with a decreased risk of ACM (AHR 0.71, 95%CI, 0.58 - 0.90, p = 0.004). An interaction term consisting of WPRT and HT use was also noted to be significant (AHR 1.61, 95%CI, 1.004 - 2.58, p = 0.048). When compared to men treated with PORT without HT, there was a significantly decreased risk ofACM in men treated with either WPRT without HT (p = 0.01) or PORT with HT (p = 0.004) as well as in men treated with bothWPRT and HT (p = 0.005). However, there was no significant decrease in the risk of ACM in men treated with both WPRT and HTwhen compared to men treated with either WPRT without HT (p = 0.51) or PORT with HT (p = 0.53).

Conclusions: The use of either WPRT or the addition of short-course HT to PORT is associated with a decreased risk of ACM inmen treated for PC, but there is no additive or synergistic benefit to combining both. These findings suggest that the shared mech-anism for this risk reduction by either WPRT or short-course HT use is sterilization of micrometastatic disease within pelvic lymphnodes.

Author Disclosure: A. Nanda, None; M. Chen, None; D. Dosoretz, None; S. Salenius, None; M. Katin, None; R. Ross, None; A.V.D’Amico, None.

2811 Portrayal of Radiation Therapy in the Press: A Survey of American Newspapers

A. J. Mundt, D. R. Simpson, S. K. Nath, B. S. Rose, L. K. Mell

University of California San Diego, La Jolla, CA

Purpose/Objective(s): Recent months have seen many negative news stories on radiation therapy (RT) which may leave readerswith concerns about the quality and delivery of RT. These articles beg the question of how RT is portrayed in the press and how itsportrayal differs from that of other oncologic specialties. The purpose of this study was to perform a review of RT-related news-paper articles assessing their tone and content, and to compare these results with those of chemotherapy (CT) articles.

Materials/Methods: Articles referring to RT and/or CT in 8 top-ranked (by circulation) newspapers published between 1/09 and 3/10 were identified using on-line archives. The following domains were assessed: title and references to efficacy, toxicity, cost andnovelty, each scored as negative, positive or neutral. References to unethical behavior or negligence were scored as negative. Totalpositive and negative scores were calculated based on the number of positive and negative references. Differences in the frequencyand mean scores between the RT and CT articles were compared using mixed models analysis to account for effects of clustering.

Results: A total of 943 articles were identified (217 RT, 481 CT, 242 both). Mean number of articles/paper was 118 (range, 30-260).Most (70%) referred to a specific disease, predominantly breast and prostate cancers. While the percentage of RT articles with RT inthe title was significantly lower than the percentage of CT articles with CT in the title (2.9 vs. 8.4%, p\0.001), the tone of RT titleswas significantly more negative (69 vs. 27%, p = 0.008). RT articles were more likely to refer to severe toxicities (17 vs. 12%, p =0.01), negligent behaviors (7 vs. 0%, p = 0.02) and less likely to refer positively to novelty (6 vs. 10%, p = 0.01). References to costswere more common in CT articles (8 vs. 5%, p = 0.06). In both groups, 23% of articles referred positively to efficacy (p = 0.78). RTarticles had a lower mean number of total positive references (0.41) compared to CT articles (0.50) (p = 0.04), with most referring toefficacy and novelty in both groups. The mean number of total negative references was comparable in the RT (0.64) and the CT(0.61) groups (p = 0.57). While most negative CT references were about mild toxicities, most negative RT references were aboutsevere toxicities. On multivariate analysis, the following characteristics were correlated with a lower cumulative score (positiveminus negative references): RT-focused (p \ 0.001), breast cancer (p = 0.05) and non-disease specific content (p = 0.001).

Conclusions: Our results suggest that RT is portrayed negatively in the press and, on many measures, more so than CT. Sinceour patients are likely readers of these articles, it is important for Radiation Oncologists to be aware of this portrayal and seekopportunities to publicize the benefits of our modality.

Author Disclosure: A.J. Mundt, None; D.R. Simpson, None; S.K. Nath, None; B.S. Rose, None; L.K. Mell, None.

2812 Adherence in Urban Radiation Oncology Patients

D. Fyffe1, C. Cathcart2

1Kessler Foundation Research Center, West Orange, NJ, 2UMDNJ-New Jersey Medical School, Newark, NJ

Purpose/Objective(s): Adherence to cancer treatment is a pressing problem for cancer patients that are not being adequately ad-dressed. Relapse-free survival and total survival rates are poorer when cancer patients delay the initiation or prematurely discon-tinue radiation therapy. Little is known about the factors that influence varying adherence levels and the clinical outcomes amongcancer patients to radiation therapy. This project examined factors associated with varying patterns of adherence among patientsseeking radiation treatment in an urban hospital.

Materials/Methods: An IRB approved standardized chart review was conducted. Data was collected using paper and electronichospital records. The sample was restricted to consecutive adult patients who received postoperative or definitive radiation therapyJanuary 2006 through April 2007 at an urban cancer center. The study team developed a measure of adherence called rho (r) asthe primary outcome variable. Rho was designed to measure how well patients adhered to prescribed fractions, and account for theweekends and holidays that fell during the course of their treatment regimen.

Results: Of the 409 patients included in the chart review, 40.3% were Black, 28.9% Hispanic/Latino and 25.2% White and theremaining 5.6% were identified as Asian or other. Half (52.1%) of the study sample was male. The mean age of patients was56.31(+/- 12.89) years. Approximately, 36.7% of the patients were married and 46.7% were unemployed. Metastatic (20.5%),