The need for complex technology in radiation oncology. Correlations of facility characteristics and structure with outcome.

The Patterns of Care Study data are used to correlate therapy equipment and practice characteristics with outcome, using Hodgkin's disease, prostate cancer, and cervix cancer as examples. The shift to linear accelerators and higher photon energy is supported, as is the increased use of treatment simulators. Part-time practitioners of radiation therapy and facilities whose only equipment is a less-than-80-cm cobalt unit have poor technical support and exhibit poor staging, poor achievement of minimum tumor dose, and poor patient follow-up as compared to the national average or best-performing strata of practice. These facilities should either upgrade their equipment, technical support, and level of practice or close.