Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi
Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi.
Jpn J Clin Oncol. 2014 Jun;44(6):579-86. doi: 10.1093/jjco/hyu041. Epub 2014 Apr 11.
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.
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).
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.
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.
本研究旨在阐明日本立体定向放疗、调强放疗和图像引导放疗的操作情况、治疗计划和流程、质量保证和质量控制。
我们采用了 109 项高精度放疗质量指标作为问卷内容。2012 年 4 月，我们开始在网站上公开该问卷，要求每台配备放疗机的机构进行回复。回复率为 62.1%（789 家机构中有 490 家回复）。
约 90%的回复机构由两名或以上放疗技师管理直线加速器的操作，而仅有 64.9%的机构由医学物理学家/放疗质量经理负责操作。仅有 18.4%的机构配备了放疗认证护士。配备肺部肿瘤立体定向放疗、调强放疗和图像引导放疗设备的机构比例分别为 43.3%、32.6%和 46.8%。在调强放疗计划中，放射肿瘤学家通常负责勾画靶区，而 33.3%的机构由医学物理学家/放疗质量经理或放疗技师设置射束。脑、头颈部和前列腺各部位调强放疗质量保证的中位时间为 4 小时。超过 60%的机构必须在临床工作时间后才能开始进行调强放疗质量保证活动。
本研究阐明了日本当前高精度放疗的一个主要问题。高精度放疗，特别是与质量保证/质量控制相关的领域，需要纠正人力短缺的问题。
