CURRENT RADIOSURGERY PRACTICE - RESULTS OF AN ASTRO SURVEY

Purpose: Although there is increasing interest in radiosurgery, little quantitative data regarding current patterns of radiosurgery practice are available. We developed a radiosurgery questionnaire to obtain in formation on radiosurgery practice. Methods and Materials: We distribu ted the questionnaire to the entire membership of the American Society of Therapeutic Radiology and Oncology in early 1993. Responses were o btained from 74 facilities that practice radiosurgery, corresponding t o over 6000 treatments carried out since 1983 by 135 radiation oncolog ists and 130 physicists. Results: Most respondents were found to work within a multidisciplinary team, consisting of the following specialis ts (average hours devoted per patient on day of treatment in parenthes es): radiation oncologist (3.8), neurosurgeon (3.2), physicist (6.1), radiologist (0.7), nurse (2.7), other (3.0). On average, neurosurgeons and nurses,who perform Gamma Knife radiosurgery devote significantly more time-per-patient on the day of treatment than their peers who per form linac radiosurgery. On average, less experienced radiation oncolo gists and physicists (less than or equal to 24 months experience, or l ess than or equal to 50 patients treated) devote significantly more ti me-per-patient on the day of treatment than their more experienced pee rs. Although there are many more linac radiosurgery facilities than Ga mma Knife facilities, on average the number of patients treated per mo nth per facility is significantly larger at the latter. On average, fo llow-up responsibilities are nearly equally shared by radiation oncolo gists and neurosurgeons, except at Gamma Knife facilities, where neuro surgeons assume a larger percentage of follow-up responsibility. The p ercentages of patients treated at linac facilities for metastases or p rimary CNS malignancy are larger than the corresponding percentages at Gamma Knife facilities; the opposite is true for arteriovenous malfor mation, acoustic neuroma, and meningioma. Conclusion: Current radiosur gery practice usually involves a team approach, with participation of specialists from radiation oncology, neurosurgery, physics, radiology, and nursing. The average number of M.D. and Ph.D. hours required per treatment on the day of radiosurgery is high.