National structure of radiation oncology in Japan with special reference to designated cancer care hospitals.
BACKGROUND
The structure of radiation oncology in designated cancer care hospitals in Japan was investigated in terms of equipment, personnel, patient load, and geographic distribution, and compared with the structure in other radiotherapy facilities.


METHODS
The Japanese Society of Therapeutic Radiology and Oncology (JASTRO) conducted a questionnaire survey about the national structure of radiation oncology in 2005. In the current study, the structures of 326 designated cancer care hospitals and the other 386 radiotherapy facilities in Japan were compared.


RESULTS
Designated cancer care hospitals accounted for 45.3% of all radiotherapy facilities. The patterns of equipment and personnel in designated cancer care hospitals and the other radiotherapy facilities were as follows: linear accelerators/facility, 1.2 and 1.0; dual-energy function, 73.1% and 56.3%; three-dimensional conformal radiotherapy function, 67.5% and 52.7%; intensity-modulated radiotherapy function, 30.0% and 13.9%; annual number of patients/linear accelerator, 289.7 and 175.1; (192)Ir remote-controlled afterloading systems, 27.6% and 8.6%; and average number of full-time equivalent radiation oncologists/facility, 1.4 and 0.9 (P < 0.0001). There were significant differences in equipment and personnel between the two types of facilities. Annual patient loads/full-time equivalent radiation oncologist in the designated cancer care hospitals and the other radiotherapy facilities were 252 and 240. Geographically, the number of designated cancer care hospitals was associated with the population, and the number of JASTRO-certified physicians was associated with the number of patients undergoing radiotherapy.


CONCLUSIONS
The Japanese structure of radiation oncology in designated cancer care hospitals was more mature than that in the other radiotherapy facilities in terms of equipment, although a shortage of personnel still exists. The serious understaffing problem in radiation oncology should be corrected in the future.
Numasaki
Hodaka
H
Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Teshima
Teruki
T
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; D006801:Humans; D007564:Japan; D018787:Radiation Oncology / Q000295:instrumentation* / Q000706:statistics & numerical data; D000078329:Workforce