A national survey of the availability of intensity-modulated radiation therapy and stereotactic radiosurgery in Canada

Abstract

BackgroundThe timely and appropriate adoption of new radiation therapy (RT) technologies is a challenge both in terms of providing of optimal patient care and managing health care resources. Relatively little is known regarding the rate at which new RT technologies are adopted in different jurisdictions, and the barriers to implementation of these technologies.MethodsSurveys were sent to all radiation oncology department heads in Canada regarding the availability of RT equipment from 2006 to 2010. Data were collected concerning the availability and use of Intensity Modulated Radiation Therapy (IMRT) and stereotactic radiosurgery (SRS), and the obstacles to implementation of these technologies.ResultsIMRT was available in 37% of responding centers in 2006, increasing to 87% in 2010. In 2010, 72% of centers reported that IMRT was available for all patients who might benefit, and 37% indicated that they used IMRT for "virtually all" head and neck patients. SRS availability increased from 26% in 2006 to 42.5% in 2010. Eighty-two percent of centers reported that patients had access to SRS either directly or by referral. The main barriers for IMRT implementation included the need to train or hire treatment planning staff, whereas barriers to SRS implementation mostly included the need to purchase and/or upgrade existing planning software and equipment.ConclusionsThe survey showed a growing adoption of IMRT and SRS in Canada, although the latter was available in less than half of responding centers. Barriers to implementation differed for IMRT compared to SRS. Enhancing human resources is an important consideration in the implementation of new RT technologies, due to the multidisciplinary nature of the planning and treatment process.

National survey on image‐guided radiotherapy practice in New Zealand

“…Our results show that all NZ centres had IMRT/VMAT capabilities, in keeping with international trends reporting increased adoption of these techniques over time. 10,12 We found a high uptake of IMRT/ VMAT in H&N and GU malignancies and selective use in other sites, similar to the trend reported in an Australian survey. 10 The strong utilization of IMRT/VMAT for H&N and GU sites is supported by the literature, with improved outcomes in these patients.…”

“…There was a broad range of number of staff members per centre for ROs (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), physicists (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and radiation therapists .…”

Advances in radiotherapy

“…For example, a survey of all cancer centres in Canada showed that the proportion of centres offering IMRT rose from 37% to 87% between 2006 and 2010. 22 In the UK, it increased from 46% to 81% between 2007 and 2012. 23 24 The key indicator for patients is access to this treatment when needed: it has been estimated that about 33% of radically treated patients should receive IMRT.…”

Practice patterns of radiation therapy technology in Australia: results of a national audit

“…Regular audits in the literature attempt to track trends in availability of radiation therapy (RT) technology such as intensity‐modulated radiotherapy (IMRT) from a range of countries . There is a big difference, however, between the availability of resources and actual usage with the resource‐hungry nature of commissioning in particular affecting implementation and usage of the available technology and equipment .…”