Clinical Operations, Pfizer R&D Japan G.K., Tokyo.
Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan.
Jpn J Clin Oncol. 2021 Feb 8;51(2):228-234. doi: 10.1093/jjco/hyaa183.
Pancreatic cancer treatment is evolving, but few studies have examined a nationwide trend in the treatment patterns. The purpose of this study was to clarify real-world treatment patterns for pancreatic cancer in Japan.
This retrospective study examined the treatment patterns among 68 479 patients, who had pancreatic cancer diagnosis in Medical Data Vision claims database from 2010 to 2018. We extracted relevant data on treatment options, including chemotherapy, surgery and their combination. For patients who had undergone chemotherapy, we sought to analyse the use of different chemotherapy regimens. In addition, we examined the trend in treatment patterns by age group (<59, 60-69, 70-79, ≥80).
The trend in treatment options of pancreatic cancer remained stable from 2010 to 2018, with chemotherapy being the most common therapeutic option and surgery performed in approximately half that of chemotherapy. On the other hand, the use of chemotherapy regimen had changed during the same period. Although gemcitabine was the most commonly administrated single-agent regimen in 2010, gemcitabine + nab-paclitaxel was the most frequently used therapeutic agent in 2018. In the older age groups (age ≥80), the majority of patients was untreated (supposedly received supportive care), and the use of conventional regimens such as gemcitabine or S-1 was common among those undergoing chemotherapy.
Although chemotherapy has been the main treatment option for pancreatic cancer, the regimens of choice have increased significantly during the last decade. With accumulating evidence on combination chemotherapy, treatment options may further evolve in the future.
胰腺癌的治疗方法在不断发展，但很少有研究调查过全国范围内胰腺癌治疗模式的趋势。本研究旨在阐明日本胰腺癌的真实治疗模式。
本回顾性研究分析了 2010 年至 2018 年在 Medical Data Vision 理赔数据库中诊断为胰腺癌的 68479 例患者的治疗模式。我们提取了与治疗选择相关的数据，包括化疗、手术及其联合治疗。对于接受化疗的患者，我们分析了不同化疗方案的使用情况。此外，我们还按年龄组（<59 岁、60-69 岁、70-79 岁、≥80 岁）检查了治疗模式的趋势。
2010 年至 2018 年，胰腺癌的治疗选择趋势保持稳定，化疗是最常见的治疗选择，手术治疗约为化疗的一半。另一方面，化疗方案的使用在此期间发生了变化。虽然吉西他滨在 2010 年是最常用的单药方案，但在 2018 年，吉西他滨+白蛋白紫杉醇是最常用的治疗药物。在年龄较大的年龄组（年龄≥80 岁）中，大多数患者未接受治疗（可能接受了支持性护理），接受化疗的患者中，吉西他滨或 S-1 等常规方案的使用率较高。
尽管化疗一直是胰腺癌的主要治疗选择，但在过去十年中，首选方案显著增加。随着联合化疗证据的积累，未来治疗选择可能会进一步发展。
