The structure of radiation oncology in the United States in 1994

Purpose: 1) to measure the basic structural characteristics of radiation oncology facilities for the entire country, providing census data for January 1, 1991; 2) to allow comparisons by facility type, equipment, or patient load; 3) to allow comparisons of the patterns of equipment and personnel to previous surveys; and 4) to make a preliminary assessment of the geographic distribution of facilities. Methods and Materials: A mail survey verified whether each potential facility delivered megavoltage radiation therapy and collected data on treatment machines, 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-standing, 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. Results: In the United States in 1994, 1542 facilities delivered megavoltage radiation therapy, with 2744 treatment machines, 2777 FTE radiation oncologists, 1349 FTE physicists, 1314 FTE dosimetrists, and 7167 FTE radiation therapists. They treated 560,262 new patients and reported that 60% were treated with curative intent. Eighty percent of the facilities had a dedicated treatment planning computer and 15% had a time-sharing treatment-planning computer, but 5% had no treatment-planning capability. Ninety-five percent of all facilities reported that patients were simulated at that facility. Fourteen percent of all facilities used hyperthermia, 8% intraoperative radiation therapy, 12% stereotactic radiosurgery, and 19% conformal therapy with 3D planning. Of all facilities 35% reported having a dedicated CT scanner and 12% reported 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 machines facilities, and for three categories based on patient load. Only 18 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 miles from a facility. Conclusion: The Facilities Surveys continue to provide a unique source of census data on radiation oncology in the United States, allowing comparisons by facility group and over time. (C) 1997 Elsevier Science Inc.