Fujita Misuzu, Nagashima Kengo, Uno Takashi, Hashimoto Hideyuki, Suzuki Kiminori, Kasai Tokuzo, Yamaguchi Kazuya, Onouchi Yoshihiro, Sato Daisuke, Fujisawa Takehiko, Hata Akira
Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba, Japan.
Department of Public Health, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Japan.
Adv Radiat Oncol. 2024 Jun 25;9(8):101555. doi: 10.1016/j.adro.2024.101555. eCollection 2024 Aug.
Hypofractionated radiation therapy (RT) was recommended for several cancer sites to reduce outpatient visits during the COVID-19 pandemic. This study aimed to identify the impact of the pandemic on hypofractionated RT for breast cancer in Japan.
The monthly number of courses for hypofractionated and conventional RTs was counted using sample data sets from the National Database of Health Insurance Claims and Specific Health Checkups of Japan, a nationwide database accumulating insurance claims data comprehensively. Changes in the number of hypofractionated and conventional RTs were estimated using an interrupted time-series analysis.
The number of hypofractionated RT courses gradually increased before the pandemic in contrast to that of conventional RT courses, which gradually decreased. However, conventional RT remained outnumbered by hypofractionated RT throughout the observation period. After the outbreak of the pandemic, the use of hypofractionated RT significantly increased in April 2020 (1312 courses; 95% CI, 801-1823) but decreased in October 2020 (-601; 95% CI, -1111 to -92). Subgroup analysis by age and the number of beds in medical institutions revealed similar trends.
Although conventional RT for breast cancer has been gradually replaced by hypofractionated RT, it remains predominant. The use of hypofractionated RT increased briefly early in the COVID-19 pandemic; however, this increase was not sustained, unlike in other countries. Considering the benefits of hypofractionated RT for breast cancer, its use should be encouraged in Japan.
在2019冠状病毒病大流行期间，超分割放射治疗（RT）被推荐用于多个癌症部位，以减少门诊就诊次数。本研究旨在确定该大流行对日本乳腺癌超分割放射治疗的影响。
使用日本全国健康保险理赔和特定健康检查数据库的样本数据集计算超分割和常规放射治疗的每月疗程数，该数据库是一个全面积累保险理赔数据的全国性数据库。使用中断时间序列分析估计超分割和常规放射治疗疗程数的变化。
与逐渐减少的常规放射治疗疗程数相比，在大流行之前超分割放射治疗疗程数逐渐增加。然而，在整个观察期内，常规放射治疗的数量仍低于超分割放射治疗。在大流行爆发后，超分割放射治疗的使用在2020年4月显著增加（1312个疗程；95%CI，801-1823），但在2020年10月减少（-601；95%CI，-1111至-92）。按年龄和医疗机构床位数进行的亚组分析显示了类似的趋势。
尽管乳腺癌的常规放射治疗已逐渐被超分割放射治疗所取代，但常规放射治疗仍然占主导地位。在2019冠状病毒病大流行早期，超分割放射治疗的使用短暂增加；然而，与其他国家不同的是，这种增加并未持续。考虑到超分割放射治疗对乳腺癌的益处，在日本应鼓励使用。
