| Malignant tumor is one of the principal diseases threatening mankind's health and radiotherapy is one of major means to treating malignancy.According to the statistics of internal and abroad data,60 to 75 percent of patients with malignant tumor have deployed radiotherapy in the process of treatment (simply radiotherapy or combined with operation or drug).In 1998,the reports announced by WHO indicated 45 percent of malignant tumors could be cured.In healable malignant tumors,22 percent are cured by operations , 18 percent by radiotherapy and 5 percent by chemotherapy.Therefore we can find that radiotherapy hold a important position in tumor therapy. Objective of the research:To find out the existing problems about radiotherapy in Jilin province and search for the solving methods by getting the message of the applied conditions of radiotherapy in Jilin province and contrasting it with domestic and international information.So we can provide a reliable basis for the development of tumor radiotherapy, reasonable disposition of radiotherapy resource and governmental policies in Jilin province. Ascertainment methods : According to government standard and correlated requirement, author investigated the conditions about every radiotherapy treatment sites by using unified questionnaires. Result:By the 30th December 2004,there are 18 radiotherapy sites and 328 radiotherapeutic operators in whole province ( including a few non-radiotherapy doctors in several departments of tumor of hospitals).Among them there are 135 doctors(41.2 percent),17 physical operators(5.2 percent),65 technologists(19.8 percent)and 111 nurses(33.8 percent).The doctors and physicists are in the ratio of8to1and the average per unit equipment technologist is 1.7.The number of various kinds of radiotherapeutic equipments is 37,in which there are 12 medical processing accelerators , 10 Co-60 teletherapeutic machines, 4 brachytherapeutic machines,8 X-knives and 3 ?-knives.The number of radiotherapeutic accessory equipments is 30,among which there are 15 simulation machines,9 dosimeters and 6 sets of radiotherapeutic planning systems.The table 3 and 6 indicated it isn't high that the total technical level of radiotherapeutic equipments in our province which is consist of home-made 10 Co-60 teletherapeutic machines and 8 accelerators.Radiotherapeutic accessory equipments are not enough and the ratio of radiotherapeutic equipments with radiotherapeutic accessory equipments is 1.3 to 1.In present,the population of our province is 26.26 million and fraction of coverage of radiotherapeutic equipments is 729.4 thousand persons per unit. Every year 4996 are treated.Radiotherapeutic periodicity is 0.19 and use ratio of equipments is 135 persons per unit. Analysis:1)Radiotherapy agency and professional staff:The disposition of radiotherapy sites is irrational and they are distributed in center cities.The developed cities, for example, Chanchun, Jilin and Siping have 11 radiotherapy sites(55.4 percent)and 221 radiotherapeutic operators (67.4 percent ). But the county has only one . Because tumor incidence is continuously increasing and sometimes tumor patients are poor,many tumor patients can not been treated effectively and promptly and living quality aredecreased.Therefore how to satisfy their requires of treating disease in the neighborhood will be next district planning and developing direction of radiotherapy in our province.Personnel matching is unreasonable.The ratio of doctors to physicists in developed country is 3 to 1,but 7.9 to 1 in our province and majority are not trained by profressors.Radiotherapy doctors,physicists and technologists are the key points of the design and performance of radiotherapeutic treatment planning and the basis of determining curative effect.The investigation shows that the level of radiotherapeutic operators don't satisfy the requires of modern radiotherapy(precise location,plan and therapy,PT)in our province.So we must carry out systemic and professional training.At same time,the elevation of medical disposition is a criticality to master advanced radiotherapeutic technology.Comparing to developed country,it is a allround system including radiotherapeutic doctors,physicists,engineers,technicians and oncobiologists.2)Radiotherapeutic equipment:The table 3 and 6 indicate it isn't high that the total technical level of radiotherapeutic equipments in our province which is consist of home-made Co-60 teletherapeutic machines and accelerators.The possessing amount per million persons of radiotherapeutic equipments in our province corresponds to that of 2 to 3 grade level of medical care.Except medical processing accelerators,others are lower than that of average level of our country.The ratio of radiotherapeutic equipments with radiotherapeutic accessory equipments is 1.3 to 1.It means that accessory equipments are short,which will certainly effect the quality of radiotherapy(table 3).Even a few hospitals have only one R-knife and this influences seriously medical treatment.3)Radiation therapy technology:Now a few of radiotherapy centers among 19radiotherapy sites in our province can apply radiation therapy technology of higher level,for example3dimensional conformal radio therapy,general irradiation,mammary gland tangential irradiation,unsymmetrical campus radiation,stereotaxis radiotherapy and radiosurgery etc.Considerable units with only one accelerator or cobalt machine keep the level of 60 's to 70's and use routine radiation methods.That confines the application of treatment technology.Some therapy sites ignore the whole development of techniques and induce medical mass deviation. 4) Quality control and quality management:from this research we find:1.clinical records aren't writed completely,especially in clinic service;2.Therapeutic lists aren't writed completely and clearly;3.Mostly departments of radiotherapy have not the regimens of clapping topogram and probation graph.A few topograms and probation graphs are not shot well and probation graphs are not shot or signed by doctors;4.Without the first positioning will lead errors of locating and theating position;5.Physicists didn't promptly record the results of checking weekly and monthly;6.Ordinance of quality control are fulfilled difficultly,because of the ignorance of leads and unsuitable administration.To keep the effect of radiotherapy ,we must ensure the radiotherapy processes are clear and scientific,operators take responsibility,the limit of authority or power is definite,messages are classic and smoothly and tables are recorded by standard. |
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