THE STRUCTURE OF RADIATION ONCOLOGY IN THE UNITED-STATES IN 1994

Purpose: 1) to measure the basic structural characteristics of radiati on oncology facilities for the entire country, providing census data f or January 1, 1991; 2) to allow comparisons by facility type, equipmen t, or patient load; 3) to allow comparisons of the patterns of equipme nt and personnel to previous surveys; and 4) to make a preliminary ass essment of the geographic distribution of facilities. Methods and Mate rials: A mail survey verified whether each potential facility delivere d megavoltage radiation therapy and collected data on treatment machin es, other equipment, personnel, new patients, and procedures performed . Responses were obtained from 99% of potential facilities. The census data was summarized for the entire country, by hospital-based, free-s tanding, or federal category, by single or multiple treatment machine group, and by new patient load category. Geographic analysis compared the center of radiation oncology facilities with the center of cities or towns having a population of more than 25,000 residents in 1990. Re sults: In the United States in 1994, 1542 facilities delivered megavol tage radiation therapy, with 2744 treatment machines, 2777 FTE radiati on oncologists, 1349 FTE physicists, 1314 FTE dosimetrists, and 7167 F TE radiation therapists. They treated 560,262 new patients and reporte d that 60% were treated with curative intent. Eighty percent of the fa cilities had a dedicated treatment planning computer and 15% had a tim e-sharing treatment-planning computer, but 5% had no treatment-plannin g capability. Ninety-five percent of all facilities reported that pati ents were simulated at that facility. Fourteen percent of all faciliti es used hyperthermia, 8% intraoperative radiation therapy, 12% stereot actic radiosurgery, and 19% conformal therapy with 3D planning. Of all facilities 35% reported having a dedicated CT scanner and 12% reporte d having a CT simulator in the department. The distributions of these measures were reported for hospital-based, free-standing, and federal facilities, for single-treatment machine, and multiple-treatment machi nes facilities, and for three categories based on patient load. Only 1 8 cities with a population over 25,000 were more than 25 miles from a radiation oncology facility, of which only eight were more than 50 mil es from a facility. Conclusion: The Facilities Surveys continue to pro vide a unique source of census data on radiation oncology in the Unite d States, allowing comparisons by facility group and over time. (C) 19 97 Elsevier Science Inc.