Trends in the practice of radiotherapy for localized prostate cancer in Japan: a preliminary patterns of care study report.
BACKGROUND
This is the first study to examine the characteristics and changes of the patterns of radiotherapy for prostate cancer in Japan.


METHODS
The Japanese Patterns of Care Study (PCS) conducted a random survey of 84 institutions nationwide. Detailed information was collected on prostate cancer patients without distant metastases, who received radiotherapy during 1996-1998 and 1999-2001.


RESULTS
The patients were divided into three groups: The Fresh Group (n = 338) was treated with radical radiotherapy with photon beams; the Surgery Group (n = 115) was treated after prostatectomy; and the Hormone-Refractory Group (n = 117) was treated after progression from hormonal therapy. In the Fresh Group, there was a decline in the fraction of patients with T3-4 tumors, from 65.2% in 1996-1998 to 43.9% in 1999-2001. In 1999-2001, a higher median dose of 69 Gy was irradiated as compared to 65 Gy in 1996-1998. In particular, the fraction of the patients treated with doses >or=70 Gy increased from 16.4% to 46.3%. In the Surgery Group, the percentage of clinical T3-4 tumors before prostatectomy decreased from 71.4% in 1996-1998 to 16.2% in 1999-2001. The median radiation dose of 60 Gy did not change, but the 1999-2001 results showed a decrease in the use of doses <60 Gy. In the Hormone-Refractory Group, the median dose increased from 60 Gy in 1996-1998 to 67 Gy in 1999-2001.


CONCLUSIONS
These data suggest that radiation doses for prostate cancer in Japan have increased dramatically within a short period of time.
Nakamura
Katsumasa
K
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Osaka, Japan. nakam@radiol.med.kyushu-u.ac.jp
Ogawa
Kazuhiko
K
Yamamoto
Tokihiro
T
Sasaki
Tomonari
T
Koizumi
Masahiko
M
Teshima
Teruki
T
Inoue
Toshihiko
T
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011468:Prostatectomy / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage
D018931:Antineoplastic Agents, Hormonal