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Historical trends of radiotherapy use in prevalent malignancies over 38 years in SEER

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

Radiation therapy (RT) has changed dramatically over the past four decades with the development of megavoltage treatment, 3D treatment planning, intensity-modulated radiation therapy (IMRT), and image guidance. Indications for RT have also changed with advances in the surgical and medical treatment of cancer. Thus, the historical trend in RT receipt as part of initial therapy is of general interest to all oncologists.

Methods

The Surveillance, Epidemiology and End Result database of the original nine sites (SEER-9) was queried with the most recent available data from 1973–2011 for the common malignancies in the USA relevant to radiotherapy (including breast, prostate, lung, colorectal, uterus, bladder, lymphoma, thyroid, oral cavity, and cervix). Cancer sites and histology were identified according to the American Joint Committee on Cancer Staging ICD-O-3 reference. Analysis was based on the percentage of nonmetastatic patients receiving radiation therapy.

Results

Radiation therapy utilization varied over the course of the 38-year study period. Breast cancer treatment peaked in 2003 and has shown a gradual decrease in the late 2000s (N = 9380; 55.8 % in 2003 vs N = 9975; 51.9 % in 2011). Although diagnosis and radiation treatment of prostate cancer rose rapidly in the 1990s, there has been a persistent decrease from 2000 to 2011 (N = 7589; 41 % in 2000 vs N = 6100; 32.2 % in 2011). The use of RT in lung cancer overall declined over the decades, but there was a relative resurgence in the last 5 years of the study. In contrast, RT for colorectal cancer has consistently increased.

Discussion

RT usage has changed significantly over the past four decades, particularly in disease sites with highest incidence, such as lung, breast and prostate cancer. As radiation oncology evolves in its technology and applications, knowledge of the changes in clinical use will be important in identifying and investing in the needed RT health resources for the future.

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Compliance with ethical standards/ethical standard statement

The study was not supported by any sources of funding. This article does not contain any studies with human participants or animals performed by any of the authors. The study did not include any human participants or identifying information through the SEER public registry requiring informed consent. The Yale University Institutional Review Board/HIC reviewed the study IRB exemption application and approved and considered this study exempt from review.

Conflict of interest

Author Dr. James Yu has received research grant funds from 21st Century Oncology and PhRMA Research Foundation. The following project was not sponsored by 21st Century Oncology or PhRMA Research Foundation. Authors Dr. Debra Yeboa, Dr. Sanjay Aneja, Dr. Gus Montana and Dr. Ken Roberts declare they have no conflicts of interest.

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Authors and Affiliations

  1. School of Medicine, Department of Therapeutic Radiology (Radiation Oncology), Yale University, New Haven, CT, USA

    Debra Nana Yeboa, Sanjay Aneja, Kenneth B. Roberts & James B. Yu

  2. Department Radiation Oncology, Duke University Medical Center, Durham, NC, USA

    Gustavo Montana

  3. Department of Therapeutic Radiology, Smilow Cancer Center at Yale-New Haven Hospital, 20 York Street, New Haven, CT, 06511, USA

    Debra Nana Yeboa

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  1. Debra Nana Yeboa
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  2. Sanjay Aneja
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Correspondence to Debra Nana Yeboa.

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Yeboa, D.N., Aneja, S., Montana, G. et al. Historical trends of radiotherapy use in prevalent malignancies over 38 years in SEER. J Radiat Oncol 4, 11–17 (2015). https://doi.org/10.1007/s13566-015-0182-y

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  • DOI: https://doi.org/10.1007/s13566-015-0182-y

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