title: Japanese structure survey of high-precision radiotherapy in 2012 based on institutional questionnaire about the patterns of care.
abstract: OBJECTIVE
  The purpose of this study was to clarify operational situations, treatment planning and processes, quality assurance and quality control with relevance to stereotactic radiotherapy, intensity-modulated radiotherapy and image-guided radiotherapy in Japan.
  
  
  METHODS
  We adopted 109 items as the quality indicators of high-precision radiotherapy to prepare a questionnaire. In April 2012, we started to publicly open the questionnaire on the website, requesting every institution with radiotherapy machines for response. The response ratio was 62.1% (490 out of 789 institutions responded).
  
  
  RESULTS
  Two or more radiotherapy technologists per linear accelerator managed linear accelerator operation in ∼90% of the responded institutions while medical physicists/radiotherapy quality managers were engaged in the operation in only 64.9% of the institutions. Radiotherapy certified nurses also worked in only 18.4% of the institutions. The ratios of the institutions equipped for stereotactic radiotherapy of lung tumor, intensity-modulated radiotherapy and image-guided radiotherapy were 43.3, 32.6 and 46.8%, respectively. In intensity-modulated radiotherapy planning, radiation oncologists were usually responsible for delineation while medical physicists/radiotherapy quality managers or radiotherapy technologists set up beam in 33.3% of the institutions. The median time required for quality assurance of intensity-modulated radiotherapy at any site of brain, head and neck and prostate was 4 h. Intensity-modulated radiotherapy quality assurance activity had to be started after clinical hours in >60% of the institutions.
  
  
  CONCLUSIONS
  This study clarified one major issue in the current high-precision radiotherapy in Japan. A manpower shortage should be corrected for high-precision radiotherapy, especially in the area relevant to quality assurance/quality control.
authors.affiliation: Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi ntomita@aichi-cc.jp.
authors.forename: Natsuo
authors.initials: N
authors.lastname: Tomita
authors.affiliation: Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kodaira
authors.affiliation: Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka.
authors.forename: Teruki
authors.initials: T
authors.lastname: Teshima
authors.affiliation: Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama.
authors.forename: Yu
authors.initials: Y
authors.lastname: Kumazaki
authors.affiliation: Department of Radiotherapy, Shiga Medical Center for Adults, Shiga.
authors.forename: Chikako
authors.initials: C
authors.lastname: Yamauchi
authors.affiliation: Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Toita
authors.affiliation: Department of Radiology, Graduate School of Medicine, Chiba University, Chiba.
authors.forename: Takashi
authors.initials: T
authors.lastname: Uno
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Minako
authors.initials: M
authors.lastname: Sumi
authors.affiliation: Department of Radiology, University of Yamanashi, Yamanashi.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
authors.affiliation: Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kenjo
authors.affiliation: Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000601:surgery; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000532:radiotherapy / Q000601:surgery; D011785:Quality Assurance, Health Care; D011786:Quality Control; D016634:Radiosurgery / Q000379:methods; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods / Q000592:standards; D011795:Surveys and Questionnaires
keywords: IGRT; IMRT; QA/QC; SRT; structure survey