Natsuo Tomita1, Takeshi Kodaira2, Teruki Teshima3, Kazuhiko Ogawa4, Yu Kumazaki5, Chikako Yamauchi6, Takafumi Toita7, Takashi Uno8, Minako Sumi9, Hiroshi Onishi10, Masahiro Kenjo11, Katsumasa Nakamura12. 1. Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi ntomita@aichi-cc.jp. 2. Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi. 3. Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka. 4. Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka. 5. Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama. 6. Department of Radiotherapy, Shiga Medical Center for Adults, Shiga. 7. Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa. 8. Department of Radiology, Graduate School of Medicine, Chiba University, Chiba. 9. Department of Radiation Oncology, National Cancer Center Hospital, Tokyo. 10. Department of Radiology, University of Yamanashi, Yamanashi. 11. Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima. 12. Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
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.
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.