3179 - Physician Utilization of Low Dose Rate and High Dose Rate Brachytherapy for Prostate Cancer in Medicare Patients over a 10-Year Span (2013-2022)

12:45pm - 02:00pm PT

Hall F

Screen: 8

POSTER

Presenter(s)

Kathryn Achuck, MD, BA - Santa Clara Valley Medical Center, San Jose, CA

K. Achuck¹, R. K. Valicenti², and X. Zhao²; ¹Thomas Jefferson University, Philadelphia, PA, ²UC Davis, Department of Radiation Oncology, Sacramento, CA

Purpose/Objective(s):

Low dose rate (LDR) and high dose rate (HDR) brachytherapy procedures have both been utilized to offer improved control and outcomes in patients requiring radiation treatment for prostate cancer. We wanted to evaluate whether one procedure was utilized more frequently and if trends for treating patients were changing over time. We hypothesized that the overall number of low dose rate (LDR) brachytherapy procedures was decreasing in prevalence and high dose rate (HDR) was increasing in prevalence over a 10-year period amongst physicians performing the procedure on patients with Medicare.

Materials/Methods:

This retrospective study utilized a 10-year data set from Medicare patients from 2013 to 2022. Initial data was filtered for each year using CPT codes “77778” as a marker for LDR and “55875” as a marker for the number of HDR procedures that occurred in the Medicare population that year. The raw data for the number of procedures per year was compared. Providers billing for either procedure in each year were subsequently evaluated for their overall brachytherapy usage in comparison to external beam. Code “77301” was used as a marker of external beam radiotherapy. The number of external beam codes was compared to the number of LDR and HDR codes to assess overall trends of LDR and HDR within the field relative to the number of patients needed to be treated by these providers.

Results:

We found that LDR procedures decreased over the 10-year span, with HDR brachytherapy overtaking the number of procedures after 2017. Both types of procedures declined significantly in the years 2020-2022. Over the same period, external beam use increased while LDR decreased in usage, and HDR increased, with decreases in all three during the 2020-2022 period. When comparing the utilization of LDR brachytherapy to external beam usage, there was a 55% reduction from 2013 – 2022. For HDR brachytherapy, there was a 41% increase over the same period.

Conclusion:

There has been a change in the utilization of LDR and HDR local therapies to treat prostate cancer over a 10-year timespan, which is driven not only by number of patients requiring treatment but physician preference on how to utilize brachytherapy amongst their patients. HDR prostate brachytherapy has replaced LDR as the primary type of brachytherapy in this Medicare population. Both procedures saw a significant decline as compared to external beam numbers during the peak years of the COVID-19 pandemic from 2020-2022.

Abstract 3179 - Table 1: LDR vs. HDR procedure by year

Year	Procedures
	LDR	HDR
2013	4374	3151
2014	3497	2419
2015	3346	2816
2016	3340	2808
2017	3430	3090
2018	3698	3819
2019	3721	3825
2020	2862	3290
2021	2686	3161
2022	2296	2968