RESUMEN
AIM: The purpose of the study was to describe infrastructures, treatment modalities, and workload in radiation oncology (RO) in Spain, referred particularly to prostate cancer (PC). METHODS: An epidemiologic, cross-sectional study was performed during 2008-2009. A study-specific questionnaire was sent to the 108 RO-registered departments. RESULTS: One hundred and two departments answered the survey, and six were contacted by telephone. Centers operated 236 treatment units: 23 (9.7 %) cobalt machines, 37 (15.7 %) mono-energetic linear accelerators, and 176 (74.6 %) multi-energy linear accelerators. Sixty-one (56.4 %) and 33 (30.5 %) departments, respectively, reported intensity-modulated radiation therapy (IMRT) and image-guided RT (IGRT) capabilities; three-dimensional-conformal RT was used in 75.8 % of patients. Virtual simulators were present in 95 departments (88.0 %), 35 use conventional simulators. Fifty-one departments (47.2 %) have brachytherapy units, 38 (35.2 %) perform prostatic implants. Departments saw a mean of 24.9 new patients/week; the number of patients treated annually was 102,054, corresponding to 88.4 % of patients with a RT indication. In 56.5 % of the hospitals, multidisciplinary teams were available to treat PC. CONCLUSIONS: Results provide an accurate picture of current situation of RO in Spain, showing a trend toward the progressive introduction of new technologies (IMRT, IGRT, brachytherapy).
Asunto(s)
Departamentos de Hospitales/organización & administración , Neoplasias de la Próstata/radioterapia , Oncología por Radiación , Carga de Trabajo , Estudios Transversales , Humanos , Masculino , España , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
OBJECTIVE: To analyze the potentials of non-conventional fractionated radiotherapy regimens for transitional cell tumors of the urinary bladder. METHODS: The biological principles and clinical aspects taken into account in the design of non-conventional fractionated radiotherapy and the possibility of incorporating the foregoing to enhance the efficacy of the treatment protocols that are widely utilized are briefly analyzed. RESULTS: Non-conventional fractionation enhances the results achieved with conventional radiotherapeutic regimens and should be included together with chemotherapy and cystectomy in the treatment of bladder cancer. CONCLUSIONS: Preservation of the bladder while maintaining or improving the cure rate continues to be the principal aim of treatment in cancer of the urinary bladder. The foregoing can be achieved with chemoradiotherapeutic regimens that include non-conventional fractionation of the radiation dose. A better understanding and knowledge of the factors that may have an influence on the therapeutic response and outcome can enhance patient selection for cystectomy.