Department of Radiation Oncology, University of Toronto, Canada.
Radiat Oncol. 2012 Feb 7;7:18. doi: 10.1186/1748-717X-7-18.
The timely and appropriate adoption of new radiation therapy (RT) technologies is a challenge both in terms of providing of optimal patient care and managing health care resources. Relatively little is known regarding the rate at which new RT technologies are adopted in different jurisdictions, and the barriers to implementation of these technologies.
Surveys were sent to all radiation oncology department heads in Canada regarding the availability of RT equipment from 2006 to 2010. Data were collected concerning the availability and use of Intensity Modulated Radiation Therapy (IMRT) and stereotactic radiosurgery (SRS), and the obstacles to implementation of these technologies.
IMRT was available in 37% of responding centers in 2006, increasing to 87% in 2010. In 2010, 72% of centers reported that IMRT was available for all patients who might benefit, and 37% indicated that they used IMRT for "virtually all" head and neck patients. SRS availability increased from 26% in 2006 to 42.5% in 2010. Eighty-two percent of centers reported that patients had access to SRS either directly or by referral. The main barriers for IMRT implementation included the need to train or hire treatment planning staff, whereas barriers to SRS implementation mostly included the need to purchase and/or upgrade existing planning software and equipment.
The survey showed a growing adoption of IMRT and SRS in Canada, although the latter was available in less than half of responding centers. Barriers to implementation differed for IMRT compared to SRS. Enhancing human resources is an important consideration in the implementation of new RT technologies, due to the multidisciplinary nature of the planning and treatment process.
及时、恰当地采用新的放射治疗（RT）技术，无论是在提供最佳患者护理还是在管理医疗资源方面，都是一个挑战。关于新的 RT 技术在不同司法管辖区的采用速度以及这些技术实施的障碍，我们知之甚少。
我们向加拿大所有放射肿瘤学部门负责人发送了有关 2006 年至 2010 年 RT 设备可用性的调查。收集了有关调强放射治疗（IMRT）和立体定向放射外科（SRS）的可用性和使用情况以及实施这些技术的障碍的数据。
2006 年，有 37%的回应中心提供了 IMRT，到 2010 年增加到 87%。2010 年，72%的中心报告称，所有可能受益的患者都可以获得 IMRT，37%的中心表示他们几乎为所有头颈部患者都使用了 IMRT。SRS 的可用性从 2006 年的 26%增加到 2010 年的 42.5%。82%的中心报告称，患者可以直接或通过转介获得 SRS。IMRT 实施的主要障碍包括需要培训或聘请治疗计划人员，而 SRS 实施的障碍主要包括需要购买和/或升级现有规划软件和设备。
调查显示，加拿大对 IMRT 和 SRS 的采用率不断提高，尽管只有不到一半的回应中心提供了后者。与 SRS 相比，IMRT 实施的障碍有所不同。由于规划和治疗过程的多学科性质，增强人力资源是实施新 RT 技术的一个重要考虑因素。
