| アブストラクト | BACKGROUND: Recently, the application of Intensity-Modulated Radiotherapy (IMRT) and changes in fractionation schedules have been increasingly introduced in radiotherapy practice for esophageal cancer. However, the extent of their adoption and prevalence in real-world clinical practice remains unclear. This study aimed to describe nationwide trends in radiotherapy for esophageal cancer using a large-scale health insurance claims database. METHODS: Using the DeSC database, we identified patients newly diagnosed with esophageal cancer between April 2017 and March 2023. Patients treated with definitive radiotherapy (defined as 25-35 treatment days in patients without distant metastasis) were selected. We analyzed temporal trends in radiotherapy, regional differences, and the incidence of radiation pneumonitis. RESULTS: Among patients with an identified initial treatment, the proportion of radiotherapy declined from 28.6% in 2017 to 19.6% in 2022. A total of 1,324 patients were included in the definitive radiotherapy group. The use of IMRT increased substantially from 10.7% in 2017 to 44.9% in 2022. Regarding fractionation, treatments of 25-28 days increased from 25.0% to 35.9%, while those of 31-35 days decreased. While CDDP/5-FU remained the dominant concurrent chemotherapy, its proportion declined as other platinum-based regimens increased. Urban facilities showed significantly higher implementation of Image-Guided Radiotherapy (IGRT) compared with rural facilities. The cumulative incidence of hospitalization for radiation pneumonitis at 12 months was 1.5%. The cumulative incidence was not significantly altered by IMRT use (sHR: 0.32, p = 0.13), whereas it was lower in patients receiving IGRT (sHR: 0.39, p = 0.04). CONCLUSIONS: This nationwide study demonstrated increased use of advanced techniques including IMRT and IGRT, and shorter fractionation schedules in radiotherapy for esophageal cancer in Japanese clinical practice. |
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| ジャーナル名 | Esophagus : official journal of the Japan Esophageal Society |
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| Pubmed追加日 | 2026/8/31 |
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| 投稿者 | Takeda, Kazuya; Okuda, Shinsaku; Umezawa, Rei; Yamamoto, Takaya; Takahashi, Noriyoshi; Onishi, Hiroshi; Jingu, Keiichi |
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| 組織名 | Department of Radiation Oncology, Tohoku University Graduate School of Medicine,;1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Miyagi, Japan.;kazuya.takeda.a8@tohoku.ac.jp.;Department of Radiation Oncology, South Miyagi Medical Center, 38-1 Nishi,;Ogawara, Shibata, 989-1253, Miyagi, Japan. kazuya.takeda.a8@tohoku.ac.jp.;Department of Radiology, Faculty of Medicine, University of Yamanashi, 4-4-37;Takeda, Kofu, 400-8510, Yamanashi, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42671685/ |
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