内蒙古自治区放射治疗现状调查

[目的]分析内蒙古自治区放射治疗机构现况,为今后资源配置和业务发展提供参考依据。[方法]通过现场调查或电话联系方式对全区24家放射治疗单位设备、业务开展和人员配置进行调查。[结果]内蒙古自治区现有放疗机构24家,12家位于东部地区,其中赤峰市最多拥有5家;12家位于西部地区,其中包头市最多拥有5家。至2008年初,全区放疗人员共计218人,全区放疗病床总数600张．放射治疗病人人数为690人次／月,常规外照射384人次／月,适形放疗238人次／月,调强放疗7人次／月,立体定向放疗48人次／月。[结论]内蒙古自治区放射治疗业务发展迅速,放疗机构和设备区域总体分布较合理。放疗专业作为临床学科认识不足,放疗人员数量和质量都有待提高,接受放疗的肿瘤病人还很少。     

甘肃省放射治疗人员和设备调查报告

摘 要：［目的］调查和分析甘肃省放射治疗人员及设备情况。［方法］2021年2月15日至2021年3月25日期间，基于甘肃省物理技术学组成立调查小组，完善调查表信息内容，通过该学组发放调查表到各医疗单位负责人，调查甘肃省内各放疗机构人员配置、设备、开展的技术以及年度治疗人次等信息。［结果］ 本次问卷回收率100.00%，所有放疗数据通过回访并由学组成员审核汇总。甘肃省内放疗机构共有23家（包括即将投入使用的单位）。从事放疗工作人员共383人，其中放疗医师177人（高级职称占比35.03%），物理师61人（高级职称占比6.56%），技师124人（高级职称占比5.64%），维修工程师21人（高级职称占比9.52%）。共有加速器32台（含进口和国产），近距离治疗机8台，重离子2台，普通模拟定位机6台，放疗专用CT模拟定位机 8台，核磁模拟定位机1台。开展二维放疗19家，三维适形放疗18家，静态调强放疗11家，开展图像引导放射治疗4家，容积旋转调强治疗3家，立体定向放射治疗1家，Cyber Knife放射治疗1家，重离子治疗1家。病床数716张（含综合医院肿瘤科病床），年度放疗人次9 474人。［结论］ 甘肃省放疗单位及放疗人员数量持续增长，但物理技术高素质人才依旧缺乏。开展新技术的放疗机构逐年增加，放疗设备和验证设备增加明显，但放疗资源依旧不足，且各区域有较大的差异。需通过持续不断努力，合理进行资源优化配置，促进新技术的应用和普及，缩小差距，切实提高甘肃省的放射治疗水平。     

2022年浙江省肿瘤放射治疗学科发展现状分析

[目的]了解浙江省肿瘤放疗学科发展情况。[方法]按浙江省肿瘤放疗质控检查标准于2021年4月—2022年10月对全省放疗单位开展放疗质控检查,调查各个医院从事放疗的人员、设备、技术、年放疗患者数等数据。[结果]全省共67家放疗单位,治疗设备共124台,定位设备83台,质控设备433台,每百万人口放疗设备拥有量为1.92台。放疗从业人员共2 301人,2022年全年总计收治患者53 978例。[结论]浙江省放疗单位在放疗组织与装置的管理、放疗临床质量管理和放射物理与技术质量管理方面均有明显进步,但依旧存在地区发展不平衡、人员进修培训缺乏、放疗专业人员较少、临床质量管理精细化程度不足等问题,需进一步改善。     

2019年中国大陆地区放疗人员和设备基本情况调查研究

[目的]了解我国大陆地区放疗人才及设备情况。[方法]2019年4月10日至9月20日期间,中华医学会放射肿瘤治疗学分会通过线上问卷的形式进行了全国第九次行业调查,调查2018年度全国各个医院从事放疗的人员、设备、技术、年放疗人次以及主要放疗病种等数据。[结果]本次问卷回收率100%,所有放疗单位数据通过各省医学会再次确认。中国大陆地区放疗单位1463家。从事放疗的工作人员共29096人,其中放疗医师14575人、物理师4172人、技师8940人、维修师1409人。共有直线加速器2021台(含进口和国产),钴60远距离治疗机66台,近距离治疗机339台,质子重离子机5台,常规模拟机1453台,CT模拟机355台。能开展二维放疗1002家,三维适形放疗1272家,静态调强放疗1121家,Rapid Arc145家,容积旋转调强放疗279家,立体定向放射治疗297家,近距离治疗273家,全身X线治疗75家,全身电子线治疗73家,Tomo治疗38家,质子/重离子治疗5家。病床数97836张(含综合医院肿瘤科病床),放疗年治疗人数1259602人。[结论]中国大陆地区放疗单位数目缓慢增长,放疗从业人员较前稍减少,开展放疗新技术单位逐年增加,全国每百万人口放疗设备(加速器+钴60)仅1.5,仍低于WHO的要求。     

“十四五”大型医用设备规划编制基础研究放射治疗组地区调查研究

目的 对中国内地放疗人员及设备现状进行调研,为“十四五”期间放疗设备科学配置和安全有效使用提供数据依据。方法 2020年10月至12月,中国医学装备协会组织专家组以线上问卷的形式开展中国内地放射治疗工作开展情况调研,调研内容包括2020年度全国放疗行业单位、专业人员、设备、技术、设备利用率、未来5年人员及设备增长预估等。数据经过各省级医学会/协会再次确认。结果 中国内地放疗单位1538家,从事放疗专业人员32978人,其中放疗医师18966人、物理师4475人、技术人员9537人;共有直线加速器2139台、⁶⁰Co机57台、近距离治疗机457台、质子重离子机6台、常规模拟机1034台、CT模拟机1208台、MR模拟机89台;能开展三维适形放疗单位1459家、固定野调强1256家、容积调强514家、近距离治疗422家;根据参与调研单位填报的预估数据汇总后,预估未来5年新增放疗医师4868人、物理师2078人、技术人员3796人;预估未来5年新增设备加速器994台、CT定位机896台、MR定位机313台、质子重离子机54台。结论 我国放疗行业发展迅速,在“十四五”期间,放疗行业还有强大的市场需求以及人员与设备增长的需求。增强国产放疗企业的市场竞争力,提高基层医院的设备利用率,提供完善系统的培训,促进标准化、规范化地临床应用等措施,有助于解决放疗资源欠缺、分布不均衡等问题,促进我国放疗事业健康快速发展。     

浙江省肿瘤放疗人员及设备现状分析

为了解近10年来浙江省肿瘤放疗的发展及现状,采用电子邮件发放＂浙江省放射治疗人员与设备情况调查表＂,调查内容包括放疗设备、人员、床位数、日治疗病人数等。截至2011年底,我省共有放疗单位37家,放疗医生384人,物理师77人,维修人员52人,技术员265人,护士532人。共有直线加速器51台,模拟定位机36台,CT模拟定位机18台,后装机13台,治疗计划系统47台,剂量仪41台,X刀5台,γ刀5台。所有放疗单位均已逐步淘汰60Co远距离治疗机及深部X机。病床2715张,日治疗病人2540人次,每年收治新患者19 984例。近10年来,我省放疗在数量、质量上都有了长足的进步,许多单位还开展了最新放疗技术,但与我省总人口相比还显不足。同时需继续开展放疗质量保证和质量控制。     

浙江省放射物理质量控制和质量保证状况分析

按照《浙江省医院肿瘤放射治疗质量保证管理规定》条例和浙江省放射物理质量控制检查评分标准,自1996年至2006年对全省的放疗单位进行放射物理质控检查,范围涉及放射治疗设备、人员、剂量检测、摆位操作规范等,汇总分析检查结果数据。浙江省的放疔设备配置呈合理规范化发展。加速器、模拟机、放射治疗计划系统、剂量设备成为肿瘤中心的基本必备设备。全省放射治疗机的输出剂量误差保持在3％以内,其它主要性能指标均达到国家标准。28家医院治疗摆位准确性检查合格率达93％。2006年全省放疗单位物理师的数量较1996年增加6倍,但仍有少数单位缺乏专职物理师。     

山西省放射治疗现状的调查

经我分会最新统计,目前全省共有16所医院(研究所)设有放射治疗科,从事故疗工作的总人数为375人,其中临床医师129人,故疗技术人员76人,放射物理人员3人,维修人员12人,放射生物人员2人,护理人员153人。放疗设备中,医用直线加速器2台,~(50)钴治疗机17台,深部X线6台,后装机19台,模拟定位机5台,治疗计划系统(TPS)2台,剂量仪9套。     

河南省肿瘤放疗现状

据统计,河南省现有钻ed放疗机cd台,直线加速器24台,近距离内照射治疗机47台,治疗计划系统4台,计量仪7台,共80余家放疗单位,分布全省各地。从事肿瘤放射治疗人员约700至800人,而多数未受过正规培训,半数以上人员由其它专业人员转行而来。学历层次偏低,业务素质较差,放疗设备不配套。该省肿瘤放疗设备大致分为三种情况：一是有内外照射机,模拟定位机,治疗计划系统,计量仪的仅有4家,占5％;H是有内外照射治疗机、模拟定位机的共20家,占25％;三是仅有外照射治疗机的有刘家。甚至有5家医院只有内照射治疗机就开展工作。河南省…     

浙江省非公立医院肿瘤放射治疗科建设情况分析

目的调查浙江省非公立医院放射治疗科建设情况及存在的问题, 提出改进建议。方法对浙江省内14家非公立医院放射治疗科2022年度建设情况开展现场检查及调研, 内容包括设备配置及来源、学科设置、人员资质及专业经历、学科带头人情况以及收治患者情况等。结果浙江省14家非公立的放射治疗医院共有治疗设备19台、定位设备15台、质控设备77台, 放疗从业人员249人, 2022年全年共收治患者4 224人。结论浙江省非公立放射治疗医院存在学科设置不科学、专业人员较少、人员进修培训缺乏、管理模式不明确、部分放疗医师人员从业资质不符合要求、临床质量管理精细化程度不足等问题, 需进一步改善。     

Current status of the infrastructure and characteristics of radiation oncology in Korea

BACKGROUND: An analysis of radiotherapy infrastructure in Korea was performed in 2006 to collect data on treatment devices, the work force and new patients for future development plans. METHODS: The survey included radiotherapy centers, their major equipment and personnel. The centers were categorized into four levels: level 0 (stand-alone teletherapy units); level 1 (teletherapy, brachytherapy, treatment planning system, and at least the part-time service of a medical physicist); level 2 (level 1 plus individual customized radiotherapy block and full-time medical physicist); and level 3 [level 2 plus intensity-modulated radiation therapy (IMRT), intra-operative radiation therapy or stereotactic radiotherapy]. RESULTS: A total of 61 facilities delivered radiation therapy with 104 megavoltage devices, which included 96 linear accelerators, two cobalt 60 units, three Tomotherapy, two CyberKnife units and one proton accelerator. There were 28,789 new radiotherapy patients in 2004. Personnel included 132 radiation oncologists, 50 radiation oncology residents, 64 physicists, 130 nurses and 369 radiation therapy technologists. Thirty-two percent (20 facilities) used a CT-simulator, 66% (40) used a PET or PET-CT scanner, and 35% (22) had the capacity to implement IMRT. Centers were also divided into four levels: 41% were included in level 3, 31% in level 2, 25% in level 1 and 3% in level 0. CONCLUSIONS: There is a shortage of human resources. The distribution of megavoltage units per million inhabitants over the country was inadequate; geographic disparities were noted. Furthermore, the necessity of quality assurance for recent high-technology radiation therapy is increasing.     

Japanese structure survey of radiation oncology in 2009 with special reference to designated cancer care hospitals

Background

The structure of radiation oncology in designated cancer care hospitals in Japan was surveyed in terms of equipment, personnel, patient load, and geographic distribution, and compared with the structure in other radiotherapy facilities and the previous survey.

Methods

The Japanese Society for Therapeutic Radiology and Oncology surveyed the national structure of radiation oncology in 2009. The structures of 365 designated cancer care hospitals and 335 other radiotherapy facilities were compared.

Results

Designated cancer care hospitals accounted for 50.0 % of all the radiotherapy facilities in Japan. The patterns of equipment and personnel in designated cancer care hospitals and the other radiotherapy facilities were, respectively, as follows: linear accelerators per facility: 1.4 and 1.0; dual-energy function: 78.6 and 61.3 %; three-dimensional conformal radiotherapy function: 88.5 and 70.0 %; intensity-modulated radiotherapy function: 51.6 and 25.3 %; annual number of patients per linear accelerator: 301.3 and 185.2; Ir-192 remote-controlled after-loading systems: 31.8 and 4.2 %; and average number of full-time equivalent radiation oncologists per facility: 1.8 and 0.8. Compared with the previous survey, the ownership ratio of equipment and personnel improved in both designated cancer care hospitals and the other radiotherapy facilities. Annual patient loads per full-time equivalent radiation oncologist in the designated cancer care hospitals and the other radiotherapy facilities were 225.5 and 247.6, respectively. These values exceeded the standard guidelines level of 200.

Conclusions

The structure of radiation oncology in designated Japanese cancer care hospitals was more mature than that in the other radiotherapy facilities. There is still a shortage of personnel. The serious understaffing problem in radiation oncology should be corrected in the future.     

2015年中国大陆放疗基本情况调查研究

目的 为进一步了解当前中国大陆地区放疗基本情况,合理配置放疗人才及设备资源,有效促进中国放疗发展,中华医学会肿瘤放疗学分会进行了第7次调查。方法 2015年10月8日到2015年12月期间,专门成立放疗基本信息调查办公室,通过各省主委提供本省放疗单位、名单及联系方式,采用专用数据填报系统通过互联网完整、快速、高效的完成调查。结果 截至2016年1月20日(1)单位:1413家;(2)人员:52496人,其中放疗医师15841人(高级职称4824人)、技师8454人(高级职称260人)、物理师3294人(高级职称562人)、维修师938人(高级职称120人);(3)放疗设备:直线加速器1931台,⁶⁰Co远距离治疗机96台,X刀171台,γ刀210台,近距离治疗机439台,X线模拟定位机1051台,CT 1353台,MRI 642台,MLC 978套,TPS 1922套,放疗网络974家;(4)质控设备:剂量仪1729台,电离室2143台,二维矩阵935台,三维剂量验证仪540台,三维水箱596台,仿真体摸844套,等效水体摸1168套;(5)治疗情况:病床数102171张(含综合医院肿瘤科病床),每日治疗76612人次,每年治疗919339人次。结论 调查结果显示中国大陆地区近年来放疗单位、放疗人员和设备均呈明显增加,放疗单位及设备分布、放疗人员结构趋于合理,但局部地区仍存在放疗设备尚不能满足医疗需求、专业技术人员缺乏等现实问题。     

Treatment of locoregional metastases of malignant melanomas with radiotherapy and intralesional beta-interferon injection

Intralesional injection of beta-interferon can lead to remission of metastatic melanomas. Simultaneous radiotherapy may augment the effect of these injections. The effect of intralesional beta-interferon injections combined with radiotherapy was examined in patients with metastatic malignant melanoma. A total of 20 patients with inoperable, incapacitating and disfiguring malignant melanoma metastases were treated with simultaneous external beam radiotherapy (electrons and/or photons) and intralesional injection of beta-interferon. The total radiation dosage ranged from 40-50 Gy, fractionated as 1.8 Gy five times per week. beta-Interferon (Fiblaferon) 3-5 million units per injection was administered three times weekly until symptoms disappeared or until termination of therapy. One patient was treated with beta-interferon alone; the area harbouring the tumour had been previously irradiated. Five patients treated in this way showed partial remission after combined therapy and 12 showed complete remission, with permanent regression of metastases. The latter group included five patients with lengthy survival times, including one patient who has been free of symptoms for 7 years following treatment. Injected metastases showed complete regression in the patient who was treated exclusively with beta-interferon post-irradiation. In conclusion, combined treatment with radiotherapy and intratumoral injection of beta-interferon controlled local tumour growth in inoperable metastatic malignant melanomas.     

Toxicity of combined treatment of adjuvant irradiation and interferon alpha2b in high-risk melanoma patients

Surgically resected stage III melanoma patients commonly receive adjuvant therapy with interferon (IFN) alpha2b. For those patients with high-risk features of draining node recurrence, radiation therapy can also be considered as a treatment option. The purpose of this retrospective study was to assess the efficacy and radiation-related toxicity of this combined therapy. Eighteen patients receiving adjuvant IFNalpha2b therapy during radiation therapy, or within 1 month of its completion, were reviewed retrospectively and analysed for outcome. Radiation was delivered at 600 cGy dose per fraction, in 16 out of 18 patients, twice a week, and at 200 cGy dose per fraction in two patients five times a week. Total radiation dose and number of fractions were as follows: 30 Gy/5 fr (n=8), 36 Gy/6 fr (n=8) and 50 Gy/25 fr (n=2). The percentage of disease-free patients, with no local recurrence, at 3 years was 88%. In 10 patients, IFNalpha2b was administered concurrently with radiotherapy; in three, within 30 days before or after radiation; and in five, more than 30 days after radiation. All the patients experienced acute skin reactions, grade I on the Radiation Therapy Oncology Group (RTOG) scale. Late radiation-related toxicity was seen in one patient with grade III (RTOG) skin reaction and two with grade IV (RTOG) radiation-induced myelitis. Concurrent use of adjuvant radiotherapy and IFNalpha2b might enhance radiation-induced toxicity, and special care should be taken when the spinal cord is included in the radiation field.     

四川省放疗工作状况调查分析

目的 分析四川省近5年来放疗工作发展水平,为全省放疗资源合理配置提供参考,促进放疗健康发展。方法 参照全国其他省份及2009年四川省放疗状况调查方案,确定调查项目;调查对象涵盖全省所有开展放疗的医疗单位,采用问卷调查和实地走访相结合的方式。结果 基础治疗条件、治疗设备、辅助设备、计划验证设备、人员配备、新技术开展方面均有很大进步。相比2009年放疗状况调查时,多个调查项目取得50%,甚至100%以上的增长。结论 四川省放射肿瘤事业的快速发展必将最终惠及四川省广大肿瘤患者,给肿瘤患者以更好地治疗环境、治疗技术和治疗质量。在取得成绩的同时,我们看到四川省放疗发展状况与国际水平,甚至与国内发达省份相比仍有不足,需要继续努力迎头赶上。     

Current and Future Challenges of Radiation Oncology in Iran: A Report from the Iranian Society of Clinical Oncology

AimsGrowth of the cancer incidence rate in Iran has been very high in recent years. Therefore, the Iranian health care system should be prepared for the treatment of a huge number of patients in the foreseeable future. One of the most important treatment options for cancer is radiation. However, there is no comprehensive information on infrastructure for radiation oncology in this country.Materials and methodsIn 2015, a questionnaire was designed by the Iranian Society of Clinical Oncology (ISCO) and all radiation oncology centres in the country were visited to determine four important components of radiation oncology services, including facilities, equipment, personnel and patients.ResultsIn 2015, 94 radiotherapy centres were identified in Iran. Sixty-one centres were fully operational, six centres were commissioning, 26 centres were under construction and one was inactive. Among the fully operational radiotherapy centres, 54 offered three-dimensional conformal radiotherapy and two-dimensional radiotherapy, eight offered brachytherapy, two intensity-modulated radiotherapy, two intraoperative radiotherapy, ostereotactic radiosurgery, two hyperthermia and 59 chemotherapy. Moreover, the survey identified 110 linear accelerators, 25 cobalt-60, one gamma knife, 21 remote brachytherapy afterloaders and six orthovoltage units. Treatment planning equipment included 15 graphy simulators, 19 dedicated computed tomography simulators, 22 multileaf collimator and 12 electronic portal imaging devices. Moreover, in 2015, 243 clinical oncologists participated in the treatment of 42 350 cancer patients in need of radiotherapy, which is about one radiation oncologist for 175 patients. During 2010–2015, number of cobalt-60 reduced 70%, from 25 units to 8 units.ConclusionsThere is a significant gap between Iran's available facilities for radiation therapy and international standards. Moreover, during international economic sanctions against Iran this gap widened.