甲状腺がんの治療に放射性ヨウ素の使用
Megan R Haymart1, Mousumi Banerjee, Andrew K Stewart
1Division of Metabolism, Endocrinology, and Diabetes, Department of Medicine, University of Michigan, Ann Arbor, MI 48109, USA. meganhay@umich.edu
JAMA
|August 18, 2011
まとめ
甲状腺がんに対する放射性ヨウ素の使用は1990年から2008年まで増加した. その適用における多くの変動は,患者または腫瘍の特徴だけでなく,病院特有の要因に関連しています.
科学分野:
- 腫瘍学 腫瘍学
- 核医学は,核医学である.
- 医療サービス 研究 医療サービス
背景:
- 甲状腺がんの治療における放射性ヨウ素 (RAI) の正確な用法については,不確実性があります.
- RAIの使用パターンは時間とともに変化し,これらのパターンに影響を与える要因は十分に理解されていません.
研究 の 目的:
- 細分化された甲状腺がんのRAI利用の動向を分析する.
- RAIの処方慣行における病院レベルの変動を調査する.
- RAIの使用に関連する患者および病院の特徴を特定するために.
主な方法:
- 米国国立がんデータベース (1990-2008) から得られた1万89219例の甲状腺がん患者を対象としたタイムトレンド分析.
- RAIの使用に影響を与える患者および病院の要因を評価するために,多層モデルが採用されました (2004-2008).
主要な成果:
- RAIの使用率は1990年の40.4%から2008年の56.0%に大幅に増加しました.
- 腫瘍の段階がRAIの使用に影響を及ぼした一方で,重要な変動が持続し,病院の特徴がこの変動のかなりの部分を説明しています.
- 病院の種類と症例量は,RAI使用と関連しており,説明できない病院の要因は,差異の29.1%を占めていた.
結論:
- 細分化された甲状腺がんにおけるRAIの使用は,過去20年間で増加しています.
- 病院間ではRAI投与の有意な差異が存在し,主に測定されていない病院固有の要因に起因する.
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