Over an 11-year period from 2002 to 2012, the largest increase in the use of various radiation therapy modalities occurred with intensity-modulated radiation therapy (IMRT) for prostate cancer (PCa), researchers concluded.

Among men undergoing radiation therapy for PCa, the proportion of those receiving IMRT rose from 3.5% in 2002 to 64% in 2012, Robert C. Miller, MD, MBA, of the Department of Radiation Oncology at Mayo Clinic in Jacksonville, Florida, and colleagues reported online in the International Journal of Radiation Oncology Biology Physics. Among adults with malignancies other than prostate cancer, IMRT use increased from 1.7% to 16.4%.

The findings are from a retrospective study using the OptumLabs Data Warehouse claims database of more than 100 million commercially insured US enrollees. Dr Miller’s team identified 474,533 patients treated with radiation therapy from 2002 to 2012. In 2002, 34.5%, 63.4%, 2.1%, 0.0%, and 0.1% of patients were treated with 3D conformal radiation therapy, 2D radiation therapy/brachytherapy, IMRT, stereotactic body radiation therapy, and proton beam radiation therapy (PBRT), respectively. In 2012, the proportions were 40.4%, 36%, 21.9%, 1.1%, and 0.6%, respectively.

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Among PCa patients receiving radiation therapy, PBRT use increased from 0.0% in 2002 to 2.6% during the study period.

PBRT use remains very low and has had little effect on overall radiation therapy use compared with IMRT, the investigators concluded. In addition, they noted, PBRT “has likely had little impact on national expenditures on cancer care in the current environment.”

The authors said their study is the largest and most geographically diverse description of radiation therapy use.

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Waddle MR, Sio TT, Van Houten HK, et al. Photon and proton radiation therapy utilization in a population of more than 100 million commercially insured patients. Int J Radiat Oncol Biol Phys. 2017; published online ahead of print. doi:10.1016/j.ijrobp.2017.07.042