Japanese structure survey of radiation oncology in 2005 based on institutional stratification of patterns of care study.
OBJECTIVE
To evaluate the structure of radiation oncology in Japan in terms of equipment, personnel, patient load, and geographic distribution to identify and improve any deficiencies.


METHODS
A questionnaire-based national structure survey was conducted between March 2006 and February 2007 by the Japanese Society of Therapeutic Radiology and Oncology. These data were analyzed in terms of the institutional stratification of the Patterns of Care Study.


RESULTS
The total numbers of new cancer patients and total cancer patients (new and repeat) treated with radiotherapy in 2005 were estimated at approximately 162,000 and 198,000, respectively. In actual use were 765 linear accelerators, 11 telecobalt machines, 48 GammaKnife machines, 64 60Co remote-controlled after-loading systems, and 119 192Ir remote-controlled after-loading systems. The linear accelerator systems used dual-energy function in 498 systems (65%), three-dimensional conformal radiotherapy in 462 (60%), and intensity-modulated radiotherapy in 170 (22%). There were 426 Japanese Society of Therapeutic Radiology and Oncology-certified radiation oncologists, 774 full-time equivalent radiation oncologists, 117 medical physicists, and 1,635 radiation therapists. Geographically, a significant variation was found in the use of radiotherapy, from 0.9 to 2.1 patients/1,000 population. The annual patient load/FTE radiation oncologist was 247, exceeding the Blue Book guidelines level. Patterns of Care Study stratification can clearly discriminate the maturity of structures according to their academic nature and caseload.


CONCLUSIONS
The Japanese structure has clearly improved during the past 15 years in terms of equipment and its use, although the shortage of manpower and variations in maturity disclosed by this Patterns of Care Study stratification remain problematic. These constitute the targets for nationwide improvement in quality assurance and quality control.
Teshima
Teruki
T
Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. teshima@sahs.med.osaka-u.ac.jp
Numasaki
Hodaka
H
Shibuya
Hitoshi
H
Nishio
Masamichi
M
Ikeda
Hiroshi
H
Ito
Hisao
H
Sekiguchi
Kenji
K
Kamikonya
Norihiko
N
Koizumi
Masahiko
M
Tago
Masao
M
Nagata
Yasushi
Y
Masaki
Hidekazu
H
Nishimura
Tetsuo
T
Yamada
Shogo
S
D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D007564:Japan; D008297:Male; D009369:Neoplasms / Q000532:radiotherapy*; D010315:Particle Accelerators / Q000600:supply & distribution; D011365:Professional Practice Location; D018787:Radiation Oncology / Q000295:instrumentation* / Q000706:statistics & numerical data; D016634:Radiosurgery / Q000295:instrumentation; D020266:Radiotherapy, Conformal / Q000295:instrumentation / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000295:instrumentation / Q000379:methods; D019233:Retreatment / Q000706:statistics & numerical data; D000078329:Workforce
D003037:Cobalt Radioisotopes; D007496:Iridium Radioisotopes