J Korean Med Sci.  2021 May;36(18):e117. 10.3346/jkms.2021.36.e117.

Implications of Radiotherapy Utilization in Korea from 2010 to 2019

• Lee J
• Kim WC
• Yoon WS
• Rim CH

• KMID: 2515854
• DOI: http://doi.org/10.3346/jkms.2021.36.e117

Abstract

Background
This study was to assess the rate of radiotherapy (RT) utilization according to the modality in South Korea to identify the implications of contemporary RT patterns.
Methods
We collected information from claims and reimbursement records of the National Health Insurance Service from 2010 to 2019. We classified the location of each institution as capital (Seoul, Incheon, and Gyeonggi-do) and non-capital areas.
Results
The rate of RT utilization in total cancer patients nationwide was 24.5% in 2010, which consistently has increased to 36.1% in 2019 (annual increase estimate [AIE], 4.5%). There was an abrupt increase in patients receiving intensity-modulated RT (IMRT), with an AIE of 33.5%, and a steady decline in patients receiving three-dimensional conformal RT (3DCRT), with an AIE of −7.1%. The commonest RT modality was IMRT (44.5%), followed by 3DCRT and stereotactic RT (SRT) (37.2% and 13.5%) in 2019. An increasing trend of advanced RT (such as IMRT and SRT) utilization was observed regardless of the region, although the AIE in the capital areas was slightly higher than that in non-capital areas.
Conclusion
The utilization of overall RT application and especially of advanced modalities remarkably increased from 2010 to 2019. We also found gaps in their AIEs between capital and non-capital areas. We should ensure that advanced RT is accessible to all cancer patients across South Korea.

Keyword

Radiotherapy; Utilization; Intensity-Modulated Radiation Therapy; Stereotactic Radiotherapy; South Korea

Figure

• 

  Fig. 1 Rate of RT utilization (number of patients who received RT/number of cancer patients) in total cancer patients and according to region between 2010 and 2019.RT = radiotherapy.

• 

  Fig. 2 Rate of RT utilization according to specific RT modality between 2010 to 2019 in South Korea.RT = radiotherapy, 3DCRT = 3-dimensional conformal radiotherapy, 2DRT = 2-dimensional radiotherapy, IMRT = intensity-modulated radiotherapy, SRT = stereotactic radiotherapy, Brachy = brachytherapy, Proton = proton therapy.

• 

  Fig. 3 Rate of advanced modality RT and 3DCRT utilization according to region (capital areas [blue lines] vs. non-capital areas [red lines]).RT = radiotherapy, 3DCRT = 3-dimensional conformal radiotherapy, IMRT = intensity-modulated radiotherapy, SRT = stereotactic radiotherapy.

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