2006年全国放疗人员及设备调查报告——纪念中华放射肿瘤学会成立20周年

目的中华放射肿瘤学会成立及第1次调查至今已20年。为了解20年来我国放疗的发展及现状,中华放射肿瘤学会在2006年对我国放疗人员及设备进行了第5次调查。方法采用了第4次调查表,仍是通过中华放射肿瘤学会各位委员将表发至各放疗单位,各单位填写后直接寄回,也有的省市由委员将调查表汇总后寄回。结果截至2006年9月30日全国共有放疗单位952个。人员共18992位,其中放射肿瘤科医师5247位(包括住院医师2110位),技术员4559位,护士6 864位,物理师1181位,维修工程技术人员1141位。设备中直线加速器918台,~(60)Co远距离治疗机472台,深部X线治疗机146台,模拟定位机827台,CT模拟定位机214台,近距离治疗机400台,治疗计划系统851台,剂量仪796台,X刀467台,γ刀149台(头部γ刀74台,体部γ刀75台)。病床数35503张(其中35家未提供病床数)。每日治疗42109人次,每年收治新患者409440人(其中49家未提供数字)。结论近5年来,我国放疗无论是数量还是质量都有了高速发展,不少单位还采用了最新技术,但与我国人口相比还是不足。今后在建立新放疗单位同时应保证放疗质量;开展再培训,特别是实际工作中再培训;制定适合我国情况的放疗质量保证及质量控制系统并贯彻执行。     

2011年中国大陆地区第六次放疗人员及设备调查

目的 中华医学会放射肿瘤学分会为了解当前中国大陆地区放疗人员及设备情况,进行了第6次调查.方法 采用了第5次调查表,仍是通过信件,电子邮件,电话及传真发送表格的方法.结果 截至2011年8月31日中国大陆地区共有放疗单位1162个.(1)人员:共3万985位,其中放射肿瘤科医师9895位(副主任医师以上3253位),技术员6103位,护士1万1689位,物理师1887位,维修工程技术人员1411位.(2)设备:直线加速器1296台,60Co远距离治疗机286台,深部线机81台,模拟定位机1040台,CT模拟定位机376台,近距离治疗机317台,治疗计划系统1427套,剂量仪1041台,X刀410台,γ刀230台(头部γ刀122台,体部γ刀108台).(3)治疗:病床5万6847张(其中4家未提供病床数),每日治疗5万8069人次(其中9家未提供数字).每年收治新患者56万9056人(其中38家未提供数字).结论 5年来,中国放疗学又有了明显的发展,人员、设备、新技术应用都有了长足进步,但离癌症患者需求还差距甚远,需要进一步努力.此外本调查还缺之质量保证与控制方面的资料.     

“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。     

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。     

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。     

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。     

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…     

粤东地区放疗物理技术及QA现状调查研究

目的 调查粤东地区放疗物理技术及QA的基本情况,为促进基层单位放疗学科建设、资源合理配置提供参考。方法 2016年3—5月利用互联网技术结合现场调查方式,对粤东地区放疗单位的一般情况、设备配置、开展技术和治疗QA方面进行了调查和统计分析。结果 截止2016年5月31日,共有放疗单位8家,开放病床数966张,日均放疗632人次,放疗从业人员222人。共有直线加速器12台,后装治疗机5台,γ刀1台,CT模拟机8台,放疗计划系统9套。5个单位开展包括IMRT/VMAT、IGRT、ART技术,精确放疗计划除1个单位外治疗前全部进行剂量验证。直线加速器、CT模拟机、后装治疗机等设备QA项目存在缺漏,专业技术人员职业培训以短期进修及老带新为主。结论 调查显示粤东地区放疗资源配置处于较低水平。地区内各单位放疗技术及QA存在明显差距,需加强放疗QA规范的建立和执行,重视专业技术人员的职业培训。     

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。     

浙江省肿瘤放疗质控检查报告

目的 通过放疗质控检查发现存在的问题,提出改进的建议或措施。方法 对浙江省内有放疗设备的45家医院进行全面的放疗质控检查,检查内容包括物理、技术、临床工作及放疗流程中与质控有关的各项参数结果 截止 2017年12月31日,45家单位共有直线加速器62台,在放疗过程中,放疗设备配置、临床工作质量、放疗技术及人员资质等方面还存在很多质控方面的问题,包括设备配置的不合理,放疗工作人员不足、临床工作流程和物理技术放疗的质量保障仍有待提高结论 定期开展放疗质控工作,对确保放疗的精准有效和医疗安全非常重要。     

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。     

Quantification of trends in radiation oncology infrastructure in Pakistan, 2004-2009

Aim: To provide objective estimates of radiation oncology infrastructure in Pakistan for the years 2004 and 2009 in order to quantify trends in radiotherapy facilities, patient load and to identify the future needs. Methods: Nationwide surveys using structured questionnaires were conducted in 2005 and 2010 by the Institute of Radiotherapy and Nuclear Medicine, Peshawar, to assess the status of radiation oncology infrastructure in 2004 and 2009. The data were analyzed to observe the trends. Results: Megavoltage teletherapy machines increased from 37 in 2004 to 41 in 2009. New patients registered in all radiotherapy centers were 33 369 in 2004 and 46 114 in 2009. Conventional simulators used for tumour localization increased from 15 to 21 and computerized tomography simulators from 0 to 07. Radiation treatment planning systems for dose calculations of tumors and vital organs increased from 15 to 26 and brachytherapy units from 12 to 13. There were 725 patients per medical physicist in 2004 versus 632 in 2009. Patients per radiation oncologist were 439 in 2004 versus 549 in 2009. Number of radiotherapy technologists/shift/machine was 1.69 in 2004 versus 1.90 in 2009. Repair maintenance personnel improved from 2.11/2 megavoltage units in 2004 to 2.49 in 2009. Conclusion: While there was an increase in number of radiotherapy centers, equipment and human resources available, this was insufficient to comply with international guidelines. An adequate enhancement in radiation oncology infrastructure is needed to cope with the predicted rise in cancer incidence.     

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.     

浙江省放射治疗质量控制和质量保证试点研究报告

目的：探讨在全省范围内进行放射治疗的质量控制与质量保证的方法。方法：自1995起，首先成立浙江省放射治疗质量控制中心（由全省放射治疗专家担任质量控制中心的指导组成员），再由专家组成员分期分批到各基层放射治疗单位进行摸底检查，然后制定出相应的管理规程（包括行政管理、设备配套、人员要求和临床治疗规范）和评分标准。自1999－2000年，再次由专家组成员到各个放射治疗单位进行逐项检查、评分，评估每个放射治疗单位的情况。结果：28个受检单位，行政管理方面均基本合格，个别单位未独立建科；设备配套情况存在部分单位或缺少模拟机，或缺少剂量仪，或仅有单光子加速器；人员方面最主要的问题是缺乏合格的放射物理师；临床治疗方面大部分科室治疗方案基本合理，但有的单位适应证选择不够严格，放射治疗技术落后，放射治疗记录不规范。将检查结果反馈给各放射治疗单位后，每个单位对其不足之处加以补充和改正，进一步规范全省的放射治疗工作。结论：由省质量控制中心对全省范围内放射治疗科进行检查，开展放射治疗质量控制和质量保证是可行的，对规范肿瘤患者的放射治疗，保证放射治疗质量，进一步开展多中心临床研究将有重要意义。     

The growth of radiation oncology in mainland China during the last 10 years

PURPOSE: This study aimed to investigate the growth of radiation oncology in mainland China during the last 10 years. METHODS AND MATERIALS: Survey questionnaires were sent to board members of the Chinese Society of Therapeutic Radiology and Oncology on Jan 1, 2006, and collected on Sept 30, 2006. Results were compared with those from 1997. RESULTS: There were 952 registered radiation oncology centers, 5,247 radiation oncologists, 1,181 physicists, 6,864 nurses, 4,559 radiotherapists, and 1,141 engineers, corresponding to 210%, 153%, 279%, 222%, 203%, and 156% growth from 1997. There were 918 linear accelerators, 472 telecobalt units, 146 deep X-ray machines, 827 fluoroscopy simulators, 796 ionization-chamber dosimeters, 400 brachytherapy units, and 851 treatment planning systems, corresponding to 321%, 124%, 82%, 249%, 264%, 142%, and 481% changes from 1997, respectively. In 2006, there were 214 computed tomography simulators, 149 Gamma Knives, and 467 x-knife machines. Approximately 61%, 48%, and 12% of radiation oncology centers performed treatments using three-dimensional conformal radiotherapy, Gamma Knife or x-knife, and intensity-modulated radiotherapy, respectively. CONCLUSION: Radiation oncology has grown remarkably, and advanced techniques have been implemented very quickly in mainland China during last 10 years, but resources are still far less than the recommendation of the World Health Organization for the population.     

云南省放疗机构现状调查

[目的]分析云南省放疗机构现状，为今后的发展方向、规模和地区分布等提供参考依据。[方法]对云南省现存资料档案中11家放射治疗单位进行现场、电话及邮件联系方式调查，总结分析云南省放疗机构、设备、人员、业务开展情况。[结果]全省11家放疗机构中7家集中位于昆明市内．直线加速器12台，9台集中于昆明市。半数放疗机构治疗和辅助设备不配套。全省无调强放射治疗机。2002年底全省总放疗人员共计147人，全省放疗物理人员仅12人。全省放疗病床数225张，放疗专科收治住院病人为164人／月(不含其它肿瘤科病人)。门诊放疗加住院放疗量总数为常规外照射11786野／月．X刀或γ刀治疗47次／月，近距离后装放疗118次／月．适形放疗116次／月。[结论]云南省放疗工作有显著进展。但放疗机构和治疗设备区域分布不合理，放疗机构人员的数量和质量都亟待提高，特别是高素质放射物理师；放疗业务开展水平较低．接受放疗的肿瘤病人还很少。     

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.     

The development of a provincial radiation oncology service: The first year report and its implications for future developments

This study compares the actual first year's workload of a new radiation oncology department with that predicted, and assesses the impact of the differences, and their implications for future similar developments. The treatment records and diaries for the Geelong Hospital Radiation Oncology Department were reviewed after the first 12 months of operation (opened in June 1992). Statistics relating to the number of patients seen, number treated, diagnosis, etc., were evaluated and compared to the original estimates based upon population statistics and likely referral rates. Nine hundred and seven new patients were seen in this period, and from them 718 courses of treatment were initiated. One hundred and eighty-nine cases (20% of referrals) were seen but not treated. A further 102 treatment courses (14% of total) were initiated upon patients who had previously been irradiated. Forty-six per cent of patients were managed by 10 fractions or fewer, and a further 23% by 25 or more fractions. Eighty per cent of patients were managed by one or two fields. Electrons were used in only 14% of cases. Further calculations suggested a further possible 441 cases of referral could be expected, based upon current population statistics. Referral rates for radiation oncology are highly dependent on a number of factors. As a result, estimates of referrals and hence the size of a department required for a given population vary widely. Our data support these concepts, and the concept that referral is also strongly dependent upon the distance patients need to travel. In considering the development of units outside of major cities it is suggested that referrals are likely to be on the high side of estimates and a minimum two-machine unit is essential to cover the given workload.     

Infrastructure of radiotherapy in Spain: a minimal standard of radiotherapy resources

PURPOSE: To assess the state of our specialty, the Spanish Society of Radiotherapy and Oncology ordered a survey of all Spanish services of radiation oncology. METHODS AND MATERIALS: In June 1999, the Society ordered an analysis of the state of radiation oncology. It created a survey that was sent to all radiotherapy units in Spain. A database was created in which 230 variables were analyzed. RESULTS: Eighty-four centers were analyzed, and 157 external beam irradiation, megavoltage units were counted, of which 67 were cobalt units and 90 were linear accelerators. The cobalt units worked an average of 11.4 h daily and the linear accelerators 11.6 h. The number of patients/unit/y was 472 for the cobalt units and 442 for the linear accelerators. The number of patients by physician and year was 179. Each center received a mean of 958 new patients annually. The average between the reception and start of treatment was 25.52 days (maximum 60), and it was estimated that only 38.1% of cancers were irradiated. The number of radiation oncologists working was 392. Spain has a deficit of 297 radiation oncologists. CONCLUSION: There is a need for 44 MV units and for the replacement of 67 cobalt units. The present lack of units has had an impact on palliative treatment, which has resulted in pharmacy costs. As long as these instrumental deficiencies are not solved, waiting lists will continue to be inherent to the system. There are also important staff deficiencies, in that about 297 radiation oncologists would be needed to cover the needs.