Japanese structure survey of radiation oncology in 2007 based on institutional stratification of patterns of care study.
OBJECTIVE
To evaluate the ongoing 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 from March to December 2008 by the Japanese Society of Therapeutic Radiology and Oncology (JASTRO). 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 radiation in 2007 were estimated at 181,000 and 218,000, respectively. There were 807 linear accelerator, 15 telecobalt, 46 Gamma Knife, 45 (60)Co remote-controlled after-loading, and 123 (192)Ir remote-controlled after-loading systems in actual use. The linear accelerator systems used dual-energy function in 539 units (66.8%), three-dimensional conformal radiation therapy in 555 (68.8%), and intensity-modulated radiation therapy in 235 (29.1%). There were 477 JASTRO-certified radiation oncologists, 826.3 full-time equivalent (FTE) radiation oncologists, 68.4 FTE medical physicists, and 1,634 FTE radiation therapists. The number of interstitial radiotherapy (RT) administrations for prostate, stereotactic body radiotherapy, and intensity-modulated radiation therapy increased significantly. Patterns of Care Study stratification can clearly identify the maturity of structures based on their academic nature and caseload. Geographically, the more JASTRO-certified physicians there were in a given area, the more RT tended to be used for cancer patients.


CONCLUSIONS
The Japanese structure has clearly improved during the past 17 years in terms of equipment and its use, although a shortage of personnel and variations in maturity disclosed by Patterns of Care Study stratification were still problematic in 2007.
Teshima
Teruki
T
Department of Medical Physics & Engineering, Osaka University Graduate School of Medicine, Suita, Japan. teshima@sahs.med.osaka-u.ac.jp
Numasaki
Hodaka
H
Shibuya
Hitoshi
H
Nishio
Masamichi
M
Ikeda
Hiroshi
H
Sekiguchi
Kenji
K
Kamikonya
Norihiko
N
Koizumi
Masahiko
M
Tago
Masao
M
Ando
Yutaka
Y
Tsukamoto
Nobuhito
N
Terahara
Atsuro
A
Nakamura
Katsumasa
K
Mitsumori
Michihide
M
Nishimura
Tetsuo
T
Hareyama
Masato
M
D001918:Brachytherapy / Q000706:statistics & numerical data; D002173:Cancer Care Facilities / Q000458:organization & administration* / Q000600:supply & distribution; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D009369:Neoplasms / Q000532:radiotherapy*; D010315:Particle Accelerators / Q000600:supply & distribution; D018787:Radiation Oncology / Q000295:instrumentation / Q000458:organization & administration*; D016634:Radiosurgery / Q000295:instrumentation; D020266:Radiotherapy, Conformal / Q000706:statistics & numerical data; D050397:Radiotherapy, Intensity-Modulated / Q000706:statistics & numerical data; D000078329:Workforce; D016526:Workload