Roberts Matthew J, Papa Nathan, Perera Marlon, Scott Susan, Teloken Patrick E, Joshi Andre, Vela Ian, Pryor David, Martin Jarad, Woo Henry
Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia.
Princess Alexandra Hospital, Brisbane, Qld, Australia.
BJU Int. 2019 Nov;124 Suppl 1:31-36. doi: 10.1111/bju.14773. Epub 2019 Sep 5.
To characterize national clinical practice trends in the treatment of prostate cancer (PCa) in Australia.
Population-level data were extracted from existing Medicare Benefits Schedule data for radical prostatectomy (RP) and brachytherapy (2002-2016), as well as external beam radiotherapy (EBRT; 2012-2016). Treatment rates were calculated relative to whole and PCa populations among privately treated patients. Overall age-related and geographical trends were analysed.
The use of RP and low-dose-rate (LDR) brachytherapy increased between 2002 and 2009, but subsequently decreased to 124 and 6.9 per 100 000 men, respectively, in 2016. More dramatic decreases were observed for men aged <65 years. From 2012, rates of RP (15% drop) and LDR brachytherapy (58% drop) decreased, while the use of EBRT remained steady, falling by 5% to 42 per 100 000 men in 2016. Overall treatment increased in the age group 75-84 years, with the rate of RP increasing by 108%.
National claims data indicate there has been a reduction in PCa treatment since 2009, which is mostly attributable to a reduction in the treatment of younger patients and reduced use of brachytherapy. RP is most commonly used and its use is rising in men aged >65 years.
描述澳大利亚前列腺癌（PCa）治疗的全国临床实践趋势。
从现有的医疗保险福利计划数据中提取了前列腺根治术（RP）和近距离放射治疗（2002 - 2016年）以及外照射放疗（EBRT；2012 - 2016年）的人群水平数据。计算了接受私人治疗患者中相对于全人群和PCa人群的治疗率。分析了总体年龄相关和地理趋势。
2002年至2009年间，RP和低剂量率（LDR）近距离放射治疗的使用有所增加，但随后分别降至2016年的每10万名男性124例和6.9例。在年龄<65岁的男性中观察到更显著的下降。从2012年起，RP（下降15%）和LDR近距离放射治疗（下降58%）的使用率下降，而EBRT的使用保持稳定，2016年降至每10万名男性42例，下降了5%。75 - 84岁年龄组的总体治疗有所增加，RP的使用率上升了108%。
全国索赔数据表明，自2009年以来PCa治疗有所减少，这主要归因于年轻患者治疗的减少和近距离放射治疗使用的减少。RP是最常用的治疗方法，其在65岁以上男性中的使用正在增加。
