Planning of radiotherapy capacity and productivity

Background and purpose: In the late 1990s a period of shortage of radiotherapy capacity caused long waiting times in The Netherlands. Investments in treatment vaults, equipment and training capacity were made. The developments since then are described and the actual situation is compared with the predictions throughout the years. Method and materials: Data are based on annual surveys on production, personnel and equipment of all 21 Dutch radiotherapy centers. Results: An annual increase in patients, radiotherapy treatments and a corresponding increase in equipment and personnel was seen, on average 3.5–4% per year. After an initial shift to more 3D conformal treatments, a subsequent change from 3D conformal to intensity modulated and image guided techniques was observed. There has been no increase in the number of radiotherapy centers and the average size of a Dutch department in 2010 was 5.7 linacs, 10.4 fte radiation oncologists, 4.8 fte physicists and 45.8 fte technologists. Conclusions: The number of linacs increased as anticipated. The increase in staffing was in balance with the need, resulting in only a limited number of vacancies. In 2010 there were virtually no waiting lists, and no overcapacity. The predicted need and the actual number of radiotherapy treatment series per year correspond very well. A national program for a planned increase of radiotherapy capacity is feasible. Expansion of existing departments instead of increasing the number allows for a more rapid introduction of new technologies and sufficient subspecialization of the staff