Department of Radiation Oncology, Hospital Ruber Internacional, Calle de la Masó, 38, 28034, Madrid, Spain.
Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut Mar, Barcelona, Spain.
Clin Transl Oncol. 2018 Mar;20(3):402-410. doi: 10.1007/s12094-017-1727-x. Epub 2017 Aug 3.
Planning for radiation oncology requires reliable estimates of both demand for radiotherapy and availability of technological resources. This study compares radiotherapy resources in the 17 regions of the decentralised Spanish National Health System (SNHS).
The Sociedad Española de Oncología Radioterápica (SEOR) performed a cross-sectional survey of all Spanish radiation oncology services (ROS) in 2015. We collected data on SNHS radiotherapy units, recording the year of installation, specific features of linear accelerators (LINACs) and other treatment units, and radiotherapeutic techniques implemented by region. Any machine over 10 years old or lacking a multileaf collimator or portal imaging system was considered obsolete. We performed a k-means clustering analysis using the Hartigan-Wong method to test associations between the gross domestic regional product (GDRP), the number of LINACs per million population and the percentage of LINACs over 10 years old.
The SNHS controls 72 (61%) of the 118 Spanish ROS and has 180 LINACs, or 72.5% of the total public and private resources. The mean rate of LINACs per million population is 3.9 for public ROS, and 42% (n = 75) of the public accelerators were obsolete in 2015: 61 due to age and 14 due to technological capability. There was considerable regional variation in terms of the number and technological capacity of radiotherapy units; correlation between GRDP and resource availability was moderate.
Despite improvements, new investments are still needed to replace obsolete units and increase access to modern radiotherapy. Regular analysis of ROS in each Spanish region is the only strategy for monitoring progress in radiotherapy capacity.
放射肿瘤学的规划需要对放疗需求和技术资源的可用性进行可靠估计。本研究比较了分散的西班牙国家卫生系统（SNHS）的 17 个地区的放射治疗资源。
西班牙放射肿瘤学会（SEOR）于 2015 年对所有西班牙放射肿瘤服务（ROS）进行了横断面调查。我们收集了 SNHS 放射治疗单位的数据，记录了安装年份、线性加速器（LINAC）和其他治疗单位的具体特征，以及按地区实施的放射治疗技术。任何超过 10 年或缺乏多叶准直器或门户成像系统的机器都被认为是过时的。我们使用 Hartigan-Wong 方法进行了 k-均值聚类分析，以测试地区生产总值（GDRP）、每百万人口的 LINAC 数量和超过 10 年的 LINAC 百分比之间的关联。
SNHS 控制了 118 个西班牙 ROS 中的 72 个（61%），拥有 180 个 LINAC，占公共和私人资源的 72.5%。每百万人口的 LINAC 平均比率为 3.9，公共 ROS 中 72%（n=75）的加速器在 2015 年已经过时：61 台是因为年代久远，14 台是因为技术能力。放射治疗单位的数量和技术能力存在相当大的地区差异；GRDP 与资源可用性之间存在中度相关性。
尽管有所改善，但仍需要新的投资来替换过时的设备，并增加获得现代放射治疗的机会。定期分析每个西班牙地区的 ROS 是监测放射治疗能力进展的唯一策略。
