BACKGROUND: To improve the quality of radiation therapy in Japan, @entity7944 ( @entity7944 ), a widely known QA program in the USA, was introduced in Japan. The feasibility was tested by collecting nationwide data by extramural audit for @entity418 . METHODS: From July 1996 through February 1997, @entity7944 audits were performed for 29 institutions. Based on the facility survey by Tsunemoto, 13 institutes were classified as A1 (university hospital/ @entity5 center treating > 300 @entity1 /year), 10 as B1 (other institutes > 120 @entity1 /year) and six as B2 (other institutes < 120 @entity1 /year). Medical charts for 455 @entity1 with @entity418 between 1992 and 1994 were reviewed based on the data format of @entity7944 in the USA. RESULTS: Concerning external beam equipment, linear accelerators of > or = 10 MV were used for 73% of @entity1 in A1, whereas in @entity15746 , 60Co machines were still used for 13% of @entity1 (P < 0.0001). The median number of full-time equivalent (FTE) radiation oncologists was 2.7 in A1, 0.65 in B1 and 0.2 in B2. Forty-five percent of @entity1 had received surgery in A1 and 34% in @entity15746 (P = 0.0068). In the non-surgery group, a higher radiation dose of > 60 Gy was delivered in A1 than in @entity15746 (P = 0.0008). Chemotherapy was administered to 51% of the @entity1 in A1 and to 30% in @entity15746 (P < 0.0001). Brachytherapy was utilized for 17% in A1 and only for 5% in @entity15746 (P = 0.0001). CONCLUSION: Institutional stratification, including equipment and personnel, significantly affected the patterns of care for @entity418 . Therefore, to improve the quality of radiation therapy nationwide, improvement of equipment and supply of FTE personnel is extremely important. @entity7944 was found to have great potential for the practical evaluation of how much will be required in Japan.

Patterns of care study of radiation therapy for XXXX in Japan: influence of the stratification of institution on the process.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity7944 :: ('MESH:C536309', 'Disease') :: ['PCS', 'Patterns of Care Study'] @entity418 :: ('MESH:D004938', 'Disease') :: ['esophageal cancer', 'thoracic esophageal cancer'] @entity15746 :: ('4709', 'Gene') :: ['B1-2']
@entity418 :: (MESH:D004938,Disease) :: ['esophageal cancer']
