A comparison of the structure of radiation oncology in the United States and Japan

Teshima, Teruki; Owen, Jean B.; Hanks, Gerald E.; Sato, Shin-ichiro; Tsunemoto, H; Inoue, Toshihiko

doi:10.1016/0360-3016(95)02046-2

Cited by 45 publications

(32 citation statements)

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“…The number of patients with brain metastasis decreased slightly by -4.7% compared with 2007 [6]. were not related to prefectural population density as was also observed in the data for 1990 [3].…”

Section: Staffing Patterns and Patient Loadssupporting

confidence: 70%

“…Therefore, monitoring these structural data is necessary to convince local government to improve working environments for ROs. Even under these conditions, however, the number of FTE ROs increased by 2.57 times compared with 1990 [3], and by 13.7% over 2007 [6]. On the other hand, patient load per FTE RO also increased by 1.35 times to 231.9 during the same period 1990-2009, but registered a -0.67% decrease compared A unique, hybrid education system for medical physicists has thus been developed in Japan since the Cancer Control Act actively started to support improvement in quality assurance and quality control (QA/QC) specialization for RT.…”

Section: Discussionmentioning

confidence: 92%

“…This number and corresponding rate have increased steadily over the last 19 years and is expected to increase further [14]. In 1990, the rate was estimated to be approximately 15% [3], and it was 16% in 1995, 17% in 1997, 20% in 1999, 22% in 2001, 23.3% in 2003 [4], 24.5% in 2005 [5], 26.1% in 2007 [6] and 27.6% in 2009. Co RALS-type systems in use did not increase.…”

Section: Resultsmentioning

confidence: 98%

See 2 more Smart Citations

Japanese Structure Survey of Radiation Oncology in 2007 Based on Institutional Stratification of Patterns of Care Study

Teshima

Numasaki

Shibuya

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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The ongoing structure of radiation oncology in Japan in terms of equipment, personnel, patient load and geographic distribution was evaluated in order to radiation identify and improve any deficiencies. A questionnaire-based national structure survey was conducted from March 2010 to January 2011 by the Japanese Society for Therapeutic Radiology and Oncology (JASTRO). These data were analyzed in terms of the institutional stratification of the Patterns of Care Study (PCS). The total numbers of new cancer patients and total of cancer patients (new and repeat) treated with radiation in 2009 were estimated at 201,000 and 240,000, respectively. The type and numbers of systems in actual use consisted of Linac (816), telecobalt (9), Gamma Knife (46), 60 Co remote afterloading system (RALS) (29) and 192 Ir RALS systems (130). The Linac systems used dual energy function for 586 (71.8%), 3DCRT for 663 (81.3%) and IMRT for 337 units (41.3%). There were 529 JASTRO-certified radiation oncologists (ROs), 939.4 full-time equivalent (FTE) ROs, 113.1 FTE medical physicists and 1836 FTE radiation therapists. The frequency of interstitial radiation therapy use for prostate and of intensity-modulated radiotherapy increased significantly. PCS stratification can clearly identify the maturity of structures based on their academic nature and caseload. Geographically, the more JASTRO-certified physicians there were in a given area, the more radiation therapy tended to be used for cancer patients. In conclusion, the Japanese structure has clearly improved during the past 19 years in terms of equipment and its use, although a shortage of manpower and variations in maturity disclosed by PCS stratification remained problematic in 2009.

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Section: Staffing Patterns and Patient Loadssupporting

confidence: 70%

Section: Discussionmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 98%

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Japanese Structure Survey of Radiation Oncology in 2007 Based on Institutional Stratification of Patterns of Care Study

Teshima

Numasaki

Shibuya

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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“…Japan was estimated to have 4.0 machines per million inhabitants, but there only 15% of tumour patients received radiotherapy. Japan likewise showed regional variation, with figures between 6% and 25% (14). A compilation from six provinces in northern Germany with a population of 17.36 million shows that 32 000 patients were treated in 1995 (13), which agrees fairly well with the Swedish figures.…”

Section: All Sites Combinedsupporting

confidence: 75%

Radiotherapy Practices in Sweden Compared to the Scientific Evidence

Lindholm¹,

Cavallin‐Ståhl²,

Ceberg³

et al. 2003

Acta Oncologica

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“…However, basic treatment using photons, which is currently used to treat 99% of the candidates for radiation therapy, is not sophisticated enough. A structure survey of radiation oncology in 1990 by Tsunemoto (1) and a subsequent comparative study between the USA and Japan (2) showed that more than 60% of institutions in Japan were staffed by part-time radiation oncologists and that the structure was immature and still developing.…”

Section: Introductionmentioning

confidence: 99%

Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Japan: Influence of the Stratification of Institution on the Process

Teshima

Abe²,

Ikeda

et al. 1998

Japanese Journal of Clinical Oncology

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PCSaudits were performed for 29 institutions. Based on the facility survey by Tsunemoto, 13 institutes were classified as A1 (university hospital/cancer centertreating >300 patients/year), 10 as B1 (otherinstitutes>120patients/year) and six as B2 (other institutes <120 patients/year). Medical charts for 455 patients with thoracic esophageal cancer between 1992 and 1994were reviewed based on the data format of PCS in the USA. Results: Concerning external beam equipment, linear accelerators of~1 0 MV were used for 73% of patients in A1, whereas in 81-2, 60CO machines were still used for 13%of patients (P< 0.0001). The median number of full-time equivalent (FTE) radiation oncologists was 2.7 in A1, 0.65 in B1 and 0.2 in B2. Forty-five percent of patients had received surgery in A1 and 34% in 81-2 (P= 0.0068).In the non-surgery group, a higher radiation dose of >60 Gy was delivered in A1 than in B1-2 (P = 0.0008). Chemotherapy was administered to 51 % of the patients in A1 and to 30% in B1-2 (P < 0.0001). Brachytherapy was utilized for 17% in A1 and only for 5% in B1-2 (P= 0.0001). Conclusion: Institutional stratification, including equipment andpersonnel, significantly affected the patterns of care for esophageal cancer. Therefore, to improve the quality of radiation therapy nationwide, improvement ofequipment andsupply of FTEpersonnel isextremely important. PCS was found to have great potential for the practical evaluation of how much will be required in Japan.Key words: Patterns ofCare Study -esophageal cancer -radiation therapy -quality assurance -structure offacility -radiation oncology equipment -radiation oncology personnel Received November 10,1997; accepted February 12, 1998 For reprints and all correspondence: Teruki Teshima, Department of Radiation Oncology, Osaka University Medical School, 2-2, Yamadaoka, Suita 565-0871, Japan. E-mail: teshima@sahs.med.osaka-u.ac.jp Abbreviations: PCS, Patterns of Care Study; QA, quality assurance; FTE, full-time equivalent; AJCC, American Joint Committee on Cancer; KPS, Karnofsky Performance Status; AI, university hospital/cancer center treating ;::300 patients/year; B1, other institutions treating ;::20patients/year; B2, other institutions treating < 120 patients/year INTRODUCTION Radiation therapy is expected to play an important role in cancer management in the next century because of a rapid increase in the number of elderly patients in Japan. These patients are generally not suitable candidates for aggressive surgery or chemotherapy. In the field of radiation oncology, many innovative techniques such as conformal therapy, intraoperative radiation therapy and heavy ion medical accelerator therapy have been developed by pioneers in Japan. However, basic treatment using photons, which is currently used to treat 99% of the candidates for radiation therapy, is not sophisticated enough. A structure survey of radiation oncology in 1990 by Tsunemoto (1) and a subsequent comparative study between the USA and Japan (2) showed that more than 60% of institutions in Japan we...

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A comparison of the structure of radiation oncology in the United States and Japan

Cited by 45 publications

References 1 publication

Japanese Structure Survey of Radiation Oncology in 2007 Based on Institutional Stratification of Patterns of Care Study

Japanese Structure Survey of Radiation Oncology in 2007 Based on Institutional Stratification of Patterns of Care Study

Radiotherapy Practices in Sweden Compared to the Scientific Evidence

Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Japan: Influence of the Stratification of Institution on the Process

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