前列腺癌治疗的利用趋势。
Utilization trends in prostate cancer therapy.
机构信息
Integrated Medical Professionals, Melville, New York 11747, USA.
出版信息
J Urol. 2011 Sep;186(3):860-4. doi: 10.1016/j.juro.2011.04.075. Epub 2011 Jul 23.
PURPOSE
We determined therapeutic trends in the management of adenocarcinoma of the prostate, and in the case of intensity modulated radiation therapy we investigated whether site of service influenced those trends.
MATERIALS AND METHODS
A variety of CPT codes to treat adenocarcinoma of the prostate were extracted from the Medicare Part B 5% sample for the years 2006 to 2008 inclusive. Data were stratified by year, type of service and, in the case of radiation therapy, site of service. Treatment trends were calculated by indexing the total number of Medicare beneficiaries receiving a service against needle biopsies of the prostate.
RESULTS
The percentage of Medicare beneficiaries receiving therapy indexed to needle biopsies of the prostate increased from 43.8% in 2006 to 49.0% in 2008. Trends in radiation and surgery were similar with 11.5% and 13% increases in each modality, respectively. Total Medicare beneficiaries receiving intensity modulated radiation therapy and laparoscopic radical prostatectomy increased by 25.4% and 22.1%, respectively, while Medicare beneficiaries treated with open radical prostatectomy and 3-dimensional conformal radiation therapy decreased by 27.9% and 37.6%, respectively. The pattern of use for intensity modulated radiation therapy was similar in physician office and hospital facility settings, increasing from 7.3% to 11.1% and 8.3% to 11.3% of Medicare beneficiaries indexed to needle biopsies of the prostate receiving intensity modulated radiation therapy at these sites in 2008, respectively.
CONCLUSIONS
Treatment trends in surgery and radiation strongly favor newer technologies, and in the case of intensity modulated radiation therapy, utilization trends for treatment of adenocarcinoma of the prostate are similar across all sites of service.
目的
我们确定了前列腺腺癌治疗的趋势，在调强放疗的情况下，我们调查了服务地点是否影响了这些趋势。
材料与方法
从 2006 年至 2008 年的 Medicare Part B 5%样本中提取了各种治疗前列腺腺癌的 CPT 代码。根据年份、服务类型进行分层，在放疗的情况下，还根据服务地点进行分层。通过将接受服务的 Medicare 受益人数索引到前列腺针吸活检数来计算治疗趋势。
结果
接受前列腺腺癌治疗的 Medicare 受益人数百分比从 2006 年的 43.8%增加到 2008 年的 49.0%。放疗和手术的趋势相似，每种模式分别增加了 11.5%和 13%。接受调强放疗和腹腔镜根治性前列腺切除术的 Medicare 受益人数分别增加了 25.4%和 22.1%，而接受开放性根治性前列腺切除术和 3 维适形放疗的 Medicare 受益人数分别减少了 27.9%和 37.6%。调强放疗的使用模式在医生办公室和医院设施环境中相似，从 2008 年接受前列腺针吸活检的 Medicare 受益人数中，调强放疗的比例分别从 7.3%增加到 11.1%和从 8.3%增加到 11.3%。
结论
手术和放疗的治疗趋势强烈倾向于新技术，在调强放疗的情况下，前列腺腺癌治疗的利用趋势在所有服务地点都相似。
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