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. 2024 Mar 22;65(2):168-176.
doi: 10.1093/jrr/rrad099.

Patterns of care for brachytherapy in Japan

Hitoshi Ikushima  1 , Noriko Ii  2 , Shin-Ei Noda  3 , Koji Masui  4 , Naoya Murakami  5 , Ken Yoshida  6 , Miho Watanabe  7 , Shinnji Kawamura  8 , Toru Kojima  9 , Yoshihito Nomoto  10 , Takafumi Toita  11 , Tatsuya Ohno  12 , Hideyuki Sakurai  13 , Hiroshi Onishi  14
Affiliations

Patterns of care for brachytherapy in Japan

Hitoshi Ikushima et al. J Radiat Res. .

Abstract

This study aimed to assess the current state of brachytherapy (BT) resources, practices and resident education in Japan. A nationwide survey was undertaken encompassing 177 establishments facilitating BT in 2022. Questionnaires were disseminated to each BT center, and feedback through online channels or postal correspondence was obtained. The questionnaire response rate was 90% (159/177), and every prefecture had a response in at least one center. The number of centers in each prefecture ranged from 0.6 to 3.6 (median: 1.3) per million population. The annual number of patients in each center ranged from 0 to 272 (median: 31). While most prefectures provided intracavitary (IC) BT for gynecological cancers and interstitial (IS) BT for prostate cancer, only one-third of the prefectures provided IS BT for cancer sites other than the prostate. The institutional image-guided BT implementation rate was 71%. IC and IS BT was performed for 15.4% of IC BT cases of gynecological cancer. Only 47% of the BT training centers answered that they could provide adequate training in BT for residents. The most common reason for this finding was the insufficient number of patients in each center. The results show that, although BT has achieved uniformity in terms of facility penetration, new technologies are not yet widespread enough. Furthermore, IS BT, which requires advanced skills, is limited to a few BT centers, and considerable number of BT training centers do not have sufficient caseloads to provide the necessary experience for their residents.

Keywords: brachytherapy; medical resources; national survey; patterns of care; resident education.

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Conflict of interest statement

Naoya Murakami reported grants from Elekta K.K., and honoraria from Medicaline K.K., AstraZeneca plc, and Chiyoda Technol Corporation. Ken Yoshida reported advisory role of Chiyoda Technol Corporation. Hideyuki Sakurai reported grants from Hitachi Co. Ltd. The other authors have no conflicts of interest to declare regarding this study.

Figures

Fig. 1
Fig. 1
Number of BT centers per million population per prefecture. The islands of Kagoshima and Okinawa Prefectures are shown in the upper left of the map.
Fig. 2
Fig. 2
Types of remote after-loading systems (RALS) used for HDR BT and types of radioisotopes used for LDR BT. Ir = iridium, Co = cobalt, I = iodine, Au = aurum, Cs = cesium, Ru = ruthenium, Rh = rhodium.
Fig. 3
Fig. 3
Average waiting period of patients for BT.
Fig. 4
Fig. 4
Total annual number of patients treated by BT in 2021 in each prefecture.
Fig. 5
Fig. 5
Distribution of the total annual number of patients treated by BT in 2021 in each center.
Fig. 6
Fig. 6
Number of patients treated by BT in 2021 according to the organ site and treatment modality.
Fig. 7
Fig. 7
The diseases and treatment techniques that could be entrusted to be performed alone after the completion of training.
See this image and copyright information in PMC

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