{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T06:02:50Z","timestamp":1780120970226,"version":"3.54.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Shizuoka Prefecture","award":["Shizuoka Prefecture"],"award-info":[{"award-number":["Shizuoka Prefecture"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Jpn J Radiol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Palliative radiation therapy (pRT) is a standard treatment option for bone metastases from malignancies and is recommended in current guidelines. Patients should have an equal opportunity to receive pRT regardless of their residential address or the location of the treatment facility; however, the frequency of use of pRT varied across regions and healthcare systems in studies in North America. This study aimed to examine the disparity in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We conducted a historical cohort study using a regional population-based cohort that included medical insurance data to examine practice disparities in pRT for patients diagnosed with bone metastases who received bone-modifying agents (BMA). The analyses focused on the secondary medical areas (SMA) where the patients lived and facilities where they were treated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 6289 patients were included in our study, and 39.6% received pRT. The regional disparity in the proportion of pRT delivery was not large, despite some areas having no facilities with RT devices. However, differences among facilities where BMA was initiated were substantial. The BMA facilities with RT devices had a higher proportion of pRT than those without RT devices. In addition, the difference was wide among the facilities with RT devices. Patients treated with BMA in designated cancer hospitals were likely to receive pRT than those of other hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This population-based study using medical claims data demonstrated practice disparities in pRT for bone metastases, particularly at the facility level. To improve this disparity, facility-level strategies seem to be more effective than SMA-level approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11604-025-01938-8","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T04:14:08Z","timestamp":1768364048000},"page":"1071-1078","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Practice disparities in palliative radiation therapy for bone metastases: insights from the Shizuoka Kokuho database study"],"prefix":"10.1007","volume":"44","author":[{"given":"Yuhei","family":"Miyasaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Harada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsumasa","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Ohno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiichiro","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"1938_CR1","doi-asserted-by":"publisher","first-page":"115783","DOI":"10.1016\/j.bone.2020.115783","volume":"158","author":"C Ryan","year":"2022","unstructured":"Ryan C, Stoltzfus KC, Horn S, Chen H, Louie AV, Lehrer EJ, et al. Epidemiology of bone metastases. Bone. 2022;158:115783.","journal-title":"Bone"},{"key":"1938_CR2","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.prro.2024.04.018","volume":"14","author":"S Alcorn","year":"2024","unstructured":"Alcorn S, Cort\u00e9s \u00c1A, Bradfield L, Brennan M, Dennis K, Diaz DA, et al. External beam radiation therapy for palliation of symptomatic bone metastases: an ASTRO clinical practice guideline. Pract Radiat Oncol. 2024;14:377\u201397.","journal-title":"Pract Radiat Oncol"},{"key":"1938_CR3","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1200\/JCO.23.00753","volume":"42","author":"EF Gillespie","year":"2024","unstructured":"Gillespie EF, Yang JC, Mathis NJ, Marine CB, White C, Zhang Z, et al. Prophylactic radiation therapy versus standard of care for patients with high-risk asymptomatic bone metastases: a multicenter, randomized phase II clinical trial. J Clin Oncol. 2024;42:38\u201346.","journal-title":"J Clin Oncol"},{"key":"1938_CR4","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1200\/JCO.2001.19.1.137","volume":"19","author":"J Huang","year":"2001","unstructured":"Huang J, Zhou S, Groome P, Tyldesley S, Zhang-Solomans J, Mackillop WJ. Factors affecting the use of palliative radiotherapy in Ontario. J Clin Oncol. 2001;19:137\u201344. https:\/\/doi.org\/10.1200\/JCO.2001.19.1.137.","journal-title":"J Clin Oncol"},{"key":"1938_CR5","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1200\/JCO.2012.45.0585","volume":"31","author":"BA Guadagnolo","year":"2013","unstructured":"Guadagnolo BA, Liao K-P, Elting L, Giordano S, Buchholz TA, Shih Y-CT. Use of radiation therapy in the last 30 days of life among a large population-based cohort of elderly patients in the United States. J Clin Oncol. 2013;31:80\u20137. https:\/\/doi.org\/10.1200\/JCO.2012.45.0585.","journal-title":"J Clin Oncol"},{"key":"1938_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-014-0305-4","volume":"10","author":"M-AS Kress","year":"2015","unstructured":"Kress M-AS, Jensen RE, Tsai H-T, Lobo T, Satinsky A, Potosky AL. Radiation therapy at the end of life: a population-based study examining palliative treatment intensity. Radiat Oncol. 2015;10:15. https:\/\/doi.org\/10.1186\/s13014-014-0305-4.","journal-title":"Radiat Oncol"},{"issue":"1","key":"1938_CR7","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.ijrobp.2015.09.045","volume":"94","author":"WJ Mackillop","year":"2016","unstructured":"Mackillop WJ, Kong W. Estimating the need for palliative radiation therapy: a benchmarking approach. Int J Radiat Oncol Biol Phys. 2016;94(1):51\u20139. https:\/\/doi.org\/10.1016\/j.ijrobp.2015.09.045.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"1938_CR8","doi-asserted-by":"publisher","first-page":"2513","DOI":"10.1111\/cas.14847","volume":"112","author":"S Okawa","year":"2021","unstructured":"Okawa S, Tabuchi T, Nakata K, Morishima T, Koyama S, Odani S, et al. Three-year survival from diagnosis in surgically treated patients in designated and nondesignated cancer care hospitals in Japan. Cancer Sci. 2021;112:2513\u201321.","journal-title":"Cancer Sci"},{"key":"1938_CR9","doi-asserted-by":"publisher","first-page":"391","DOI":"10.2188\/jea.JE20200480","volume":"32","author":"E Nakatani","year":"2022","unstructured":"Nakatani E, Tabara Y, Sato Y, Tsuchiya A, Miyachi Y. Data resource profile of Shizuoka Kokuho Database (SKDB) using integrated health- and care-insurance claims and health checkups: the Shizuoka study. J Epidemiol. 2022;32:391\u2013400. https:\/\/doi.org\/10.2188\/jea.JE20200480.","journal-title":"J Epidemiol"},{"key":"1938_CR10","unstructured":"Shizuoka Graduate University of Public Health. Shizuoka Kokuho Database (SKDB). Available from: https:\/\/skdb.s-sph.ac.jp\/en\/."},{"key":"1938_CR11","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1093\/jrr\/rrab129","volume":"63","author":"H Numasaki","year":"2022","unstructured":"Numasaki H, Nakada Y, Okuda Y, Ohba H, Teshima T, Ogawa K. Japanese structure survey of radiation oncology in 2015. J Radiat Res. 2022;63:230\u201346. https:\/\/doi.org\/10.1093\/jrr\/rrab129.","journal-title":"J Radiat Res"},{"key":"1938_CR12","doi-asserted-by":"publisher","DOI":"10.1002\/pds.70048","volume":"33","author":"QL Her","year":"2024","unstructured":"Her QL, Rouette J, Young JC, Webster-Clark M, Tazare J. Core concepts in pharmacoepidemiology: new-user designs. Pharmacoepidemiol Drug Saf. 2024;33:e70048. https:\/\/doi.org\/10.1002\/pds.70048.","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"1938_CR13","unstructured":"R Core Team. R: A Language and Environment for Statistical Computing. 2024. Available from: https:\/\/www.R-project.org\/."},{"key":"1938_CR14","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-12883-x","volume":"15","author":"M Zhang","year":"2025","unstructured":"Zhang M, Deng H, Hu R, Chen F, Dong S, Zhang S, et al. Patterns and prognostic implications of distant metastasis in breast cancer based on SEER population data. Sci Rep. 2025;15:26717. https:\/\/doi.org\/10.1038\/s41598-025-12883-x.","journal-title":"Sci Rep"},{"key":"1938_CR15","doi-asserted-by":"publisher","first-page":"5191","DOI":"10.21037\/tcr-21-1507","volume":"10","author":"S Shi","year":"2021","unstructured":"Shi S, Wang H, Liu X, Xiao J. Prediction of overall survival of non-small cell lung cancer with bone metastasis: an analysis of the surveillance, epidemiology and end results (SEER) database. Transl Cancer Res. 2021;10:5191\u2013203. https:\/\/doi.org\/10.21037\/tcr-21-1507.","journal-title":"Transl Cancer Res"},{"issue":"1","key":"1938_CR16","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-80425-y","volume":"14","author":"E Munai","year":"2024","unstructured":"Munai E, Zeng S, Yuan Z, Yang D, Jiang Y, Wang Q, et al. Machine learning-based prediction model for brain metastasis in patients with extensive-stage small cell lung cancer. Sci Rep. 2024;14(1):28790. https:\/\/doi.org\/10.1038\/s41598-024-80425-y.","journal-title":"Sci Rep"},{"key":"1938_CR17","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5575295","volume":"2021","author":"Z Fan","year":"2021","unstructured":"Fan Z, Huang Z, Huang X. Bone metastasis in renal cell carcinoma patients: risk and prognostic factors and nomograms. J Oncol. 2021;2021:5575295. https:\/\/doi.org\/10.1155\/2021\/5575295.","journal-title":"J Oncol"},{"key":"1938_CR18","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1002\/pros.22742","volume":"74","author":"G Gandaglia","year":"2014","unstructured":"Gandaglia G, Abdollah F, Schiffmann J, Trudeau V, Shariat SF, Kim SP, et al. Distribution of metastatic sites in patients with prostate cancer: a population-based analysis: sites of metastases in PCa patients. Prostate. 2014;74:210\u20136. https:\/\/doi.org\/10.1002\/pros.22742.","journal-title":"Prostate"},{"key":"1938_CR19","doi-asserted-by":"publisher","first-page":"e2355409","DOI":"10.1001\/jamanetworkopen.2023.55409","volume":"7","author":"BJJ Bindels","year":"2024","unstructured":"Bindels BJJ, Mercier C, Gal R, Verlaan J-J, Verhoeff JJC, Dirix P, et al. Stereotactic body and conventional radiotherapy for painful bone metastases: A systematic review and meta-analysis. JAMA Netw Open. 2024;7:e2355409.","journal-title":"JAMA Netw Open"}],"container-title":["Japanese Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11604-025-01938-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11604-025-01938-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11604-025-01938-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T05:36:49Z","timestamp":1780119409000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11604-025-01938-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["1938"],"URL":"https:\/\/doi.org\/10.1007\/s11604-025-01938-8","relation":{},"ISSN":["1867-1071","1867-108X"],"issn-type":[{"value":"1867-1071","type":"print"},{"value":"1867-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]},"assertion":[{"value":"28 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Hideyuki Harada received lecture fees from AstraZeneca and Brainlab. Tatsuya Ohno received joint research funds from Hitachi for work unrelated to the present study. The other authors have no conflict of interest to declare with respect to this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The present study was designed and conducted according to the principles outlined in the Declaration of Helsinki and the Ethical Guidelines for Medical and Health Research Involving Human Subjects. Approval for the study was granted by the institutional ethics committee (SGUPH_2021_001_073). Before receiving the SKDB data, all personal data were anonymized by the Shizuoka Federation of National Health Insurance Organizations. Information about this study was posted on the Shizuoka Graduate University of Public Health website to ensure that participants could opt out of having their data used.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}