Kojima Toru, Okamoto Hiroyuki, Kurooka Masahiko, Tohyama Naoki, Tsuruoka Ichiro, Nemoto Mikio, Shimomura Kohei, Myojoyama Atsushi, Ikushima Hitoshi, Ohno Tatsuya, Ohnishi Hiroshi
Department of Radiation Oncology, Saitama Prefectural Cancer Center, 780 Komuro, Ina-machi, Saitama 362-0806, Japan.
Division of Radiation Safety and Quality Assurance, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
J Radiat Res. 2024 Dec 3;65(6):851-861. doi: 10.1093/jrr/rrae082.
Brachytherapy (BT), especially in high dose rate (HDR), has become increasingly complex owing to the use of image-guided techniques and the introduction of advanced applicators. Consequently, radiotherapy technologists and medical physicists (RTMPs) require substantial training to enhance their knowledge and technical skills in image-guided brachytherapy. However, the current status of the RTMP workload, individual abilities and quality control (QC) of BT units in Japan remains unclear. To address this issue, we conducted a questionnaire survey from June to August 2022 in all 837 radiation treatment facilities in Japan involving RTMPs. This survey focused on gynecological cancers treated with HDR-BT (GY-HDR) and permanent prostate implantation using low-dose-rate BT (PR-LDR). The responses revealed that the average working time in the overall process for HDR varied: 120 min for intracavitary BT and 180 min for intracavitary BT combined with interstitial BT. The QC implementation rate, in accordance with domestic guidelines, was 65% for GY-HDR and 44% for PR-LDR, which was lower than the 69% observed for external beam radiation therapy (EBRT). Additionally, the implementation rate during regular working hours was low. Even among RTMP working in facilities performing BT, the proportion of those able to perform QC for BT units was ~30% for GY-HDR and <20% for PR-LDR, significantly lower than the 80% achieved for EBRT. This study highlights the vulnerabilities of Japan's BT unit QC implementation structure. Addressing these issues requires appropriate training of the RTMP staff to safely perform BT tasks and improvements in practical education and training systems.
近距离放射治疗（BT），尤其是高剂量率（HDR）近距离放射治疗，由于图像引导技术的应用和先进施源器的引入而变得日益复杂。因此，放射治疗技术人员和医学物理师（RTMPs）需要大量培训，以增强他们在图像引导近距离放射治疗方面的知识和技术技能。然而，日本RTMPs的工作量现状、个人能力以及BT单位的质量控制（QC）情况仍不明确。为解决这一问题，我们于2022年6月至8月对日本所有837家涉及RTMPs的放射治疗机构进行了问卷调查。该调查聚焦于采用HDR-BT治疗的妇科癌症（GY-HDR）以及使用低剂量率BT进行的永久性前列腺植入（PR-LDR）。调查结果显示，HDR整个过程的平均工作时间各不相同：腔内BT为120分钟，腔内BT联合组织间BT为180分钟。根据国内指南，GY-HDR的QC实施率为65%，PR-LDR为44%，低于外照射放疗（EBRT）的69%。此外，正常工作时间内的实施率较低。即使在开展BT的机构中工作的RTMPs中，能够对BT单位进行QC的人员比例，GY-HDR约为30%，PR-LDR小于20%，显著低于EBRT的80%。本研究凸显了日本BT单位QC实施结构的薄弱环节。解决这些问题需要对RTMP工作人员进行适当培训，以安全地执行BT任务，并改进实践教育和培训体系。
