Recent trends in intensity-modulated radiation therapy use in Korea

Abstract

We aimed to analyze the trend in intensity-modulated radiation therapy (IMRT) use in Korea from 2011 to 2018. Materials and Methods: We collected data from the Health and Insurance Review and Assessment Service (HIRA) big data based on the National Health Insurance Service claims and reimbursements records using primary treatment planning codes (HD 041) for IMRT from 2011 to 2018. We analyzed the changing patterns in clinical application to specific tumor sites and regional differences in IMRT utilization. Results: The use of IMRT has exhibited an 18-fold steep rise from 1,921 patients in 2011 to 34,759 in 2018. With regard to IMRT in 2018, 70% of patients (24,248/34,759) were treated in metropolitan areas (Seoul, Incheon, and Gyeonggi Province). IMRT was most commonly used to treat breast, lung, and prostate cancers in 2018. Among these, the use of IMRT for breast cancer shows the most remarkable increase from 2016 when the National Health Insurance began to cover IMRT for all solid tumors. Conclusion: The use of IMRT is steadily increasing to treat cancer and is concentrated in metropolitan areas.

Current status and comparison of national health insurance systems for advanced radiation technologies in Korea and Japan

“…According to the Japanese Society for Radiation Oncology database report of 2018, IMRT was mostly used to treat prostate, head and neck, and central nervous system tumors in Japan [17]. However, in Korea, IMRT was most commonly used to treat breast, lung, and prostate cancers in 2018 [13]. JHIS adopted stricter indications for proton and carbon ion therapy ( Table 7).…”

“…We compared characteristics, patterns of the HIS, specific indications, and facility qualification for advanced radiation technologies between Korea and Japan, focusing on IMRT, SBRT, intracavitary radiotherapy (ICR), proton, and carbon ion therapy. Furthermore, we compared both nations’ data according to the 2019 guidelines on the application and methods of medical care benefit from the Ministry of Health and Welfare of Korea and the 2020 medical fee points list set by the Ministry of Health, Labor and Welfare of Japan [ 11 - 13 ]. As the cost of insurance treatment between the two countries varies greatly due to social and economic differences, simple comparison of treatment fee was excluded from this study.…”

“…Characteristics of both nations' universal health insurance sys-tem (HIS) are: (1) covering all citizens with social insurance, (2) easy access to medical institutions, and (3) high-quality medical services with low costs and have reached the world's highest level of life expectancy and met the healthcare standards [9,10]. However, there are some differences regarding the indication, qualification standards, and facility standards for reimbursement for advanced radiation technologies [11][12][13]. This study aimed to compare the characteristics and patterns of the HIS for advanced radiation technologies between Korea and Japan by focusing on technologies such as intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and particle therapy.…”

“…Characteristics of both nations’ universal health insurance system (HIS) are: (1) covering all citizens with social insurance, (2) easy access to medical institutions, and (3) high-quality medical services with low costs and have reached the world's highest level of life expectancy and met the healthcare standards [ 9 , 10 ]. However, there are some differences regarding the indication, qualification standards, and facility standards for reimbursement for advanced radiation technologies [ 11 - 13 ].…”

Coronary Event Analysis in Breast Cancer Patients Who Received Breast-Conserving Surgery and Post-Operative Radiotherapy: a Korean Nationwide Cohort Study

“…Breast-conserving surgery (BCS) followed by adjuvant breast radiotherapy (RT) is the current standard treatment for early-stage breast cancer patients. Addition of adjuvant breast RT after lumpectomy significantly decreased the local recurrence rate and resulted in survival outcomes equivalent to those obtained from radical mastectomy [2][3][4][5]. However, studies with long-term follow-up suggested that breast RT also increased the risk of cardiovascular morbidity [6][7][8][9][10][11].…”