Clinical and Translational Oncology

, Volume 16, Issue 5, pp 447–454 | Cite as

Infrastructures, treatment modalities, and workload of radiation oncology departments in Spain with special attention to prostate cancer

  • J. López TorrecillaEmail author
  • A. Zapatero
  • I. Herruzo
  • F. A. Calvo
  • M. A. Cabeza
  • A. Palacios
  • A. Guerrero
  • A. Hervás
  • P. Lara
  • B. Ludeña Martínez
  • E. del Cerro Peñalver
  • G. Nagore
  • G. Sancho
  • J. L. Mengual
  • M. Mira
  • A. Mairiño
  • P. Samper
  • S. Pérez
  • I. Castillo
  • J. C. Martínez Cedrés
  • E. Ferrer
  • S. Rodriguez
  • X. Maldonado
  • A. Gómez Caamaño
  • C. Ferrer
  • On behalf of the Grupo de Investigación GICOR-URONCOR-SEOR
Special Article



The purpose of the study was to describe infrastructures, treatment modalities, and workload in radiation oncology (RO) in Spain, referred particularly to prostate cancer (PC).


An epidemiologic, cross-sectional study was performed during 2008–2009. A study-specific questionnaire was sent to the 108 RO-registered departments.


One hundred and two departments answered the survey, and six were contacted by telephone. Centers operated 236 treatment units: 23 (9.7 %) cobalt machines, 37 (15.7 %) mono-energetic linear accelerators, and 176 (74.6 %) multi-energy linear accelerators. Sixty-one (56.4 %) and 33 (30.5 %) departments, respectively, reported intensity-modulated radiation therapy (IMRT) and image-guided RT (IGRT) capabilities; three-dimensional-conformal RT was used in 75.8 % of patients. Virtual simulators were present in 95 departments (88.0 %), 35 use conventional simulators. Fifty-one departments (47.2 %) have brachytherapy units, 38 (35.2 %) perform prostatic implants. Departments saw a mean of 24.9 new patients/week; the number of patients treated annually was 102,054, corresponding to 88.4 % of patients with a RT indication. In 56.5 % of the hospitals, multidisciplinary teams were available to treat PC.


Results provide an accurate picture of current situation of RO in Spain, showing a trend toward the progressive introduction of new technologies (IMRT, IGRT, brachytherapy).


Radiotherapy Infrastructure Workload Prostate cancer 



We thank all the participants in the study for helping to contribute to a greater understanding of the situation of RO in Spain; the participant’s names and affiliations are listed in "Appendix". We also thank Astellas Pharma S.A. for their support in this project.

Conflict of interest

All authors declared no conflicts of interest.


  1. 1.
    Comisión de las Sociedades Oncológicas para la Planificación Oncológica en España Libro Blanco de la Oncología en España. Informe para la Planificación global de la Oncología. Ed. Jims, Barcelona; 1988.Google Scholar
  2. 2.
    López-Torrecilla J, Guedea F, Heeren G, Nissin R, Ellison T, Cottier B. Patterns of care for brachytherapy in Europe. Results in Spain. Clin Transl Oncol. 2006;8(5):362–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P. Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol. 2007;18(3):581–92.PubMedCrossRefGoogle Scholar
  4. 4.
    Zapatero A, López-Torrecilla J, Herruzo I, Calvo FA, SEOR URONCOR GICOR participating Investigators. Practice patterns in the management of prostate cancer in Spain: results from a national survey among radiation oncologists in 2009. Clin Transl Oncol. 2013;15(3):226–32.PubMedCrossRefGoogle Scholar
  5. 5.
    Zapatero A, Valcarcel F, Calvo FA, Alga’s R, Béjar A, Maldonado J, et al. Risk-adapted androgen deprivation and escalated three-dimensional conformal radiotherapy for prostate cancer: does radiation dose influence outcome of patients treated with adjuvant androgen deprivation? A GICOR study. J Clin Oncol. 2005;23(27):6561–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Slotman BJ, Cottier B, Bentzen SM, Heeren G, Lievens Y, van den Bogaert W. Overview of national guidelines for infrastructure and staffing of radiotherapy. ESTRO-QUARTS: workpackage 1. Radiother Oncol. 2005;75(3):349–54.PubMedCrossRefGoogle Scholar
  7. 7.
    Porter A, Aref A, Chodounsky Z, Elzawawy A, Manatrakul N, Ngoma T, et al. A global strategy for radiotherapy: a WHO consultation. Clin Oncol (R Coll Radiol). 1999;11:368–70.Google Scholar
  8. 8.
    Herruzo Cabrera I, Espinosa Calvo M, López-Torrecilla J, Maciá Garau M, Palacios Eito A, Sánchez Calzado J, et al. Cálculo de necesidades e infraestructura en España. In: Libro Blanco SEOR-XXI. Análisis de la situación, necesidades y recursos de la Oncología Radioterápica. Editores Médicos, SA. EDIMSA, Madrid; 2010;65–85.Google Scholar
  9. 9.
    Martínez García C, Sánchez Pérez MJ, Borrás-i-Andrés JM. El Cáncer en España: Epidemiología descriptiva in: Libro Blanco SEOR-XXI. Análisis de la situación, necesidades y recursos de la Oncología Radioterápica. Editores Médicos, SA. EDIMSA. Madrid; 2010;9–40.Google Scholar
  10. 10.
    Cortes F, Díaz R, García V, Herranz C, Martinez C, Muñoz Villa A, et al. Segundo Libro Blanco de la Oncología Española. ENE Publicidad; Madrid; 1995.Google Scholar
  11. 11.
    Palacios Eito A, Espinosa Calvo M, Mañas Rueda A, de las Heras González M. Equipamiento y necesidades futuras. Situación actual en España. Revisiones en Cáncer 2006;20(5):205–12.Google Scholar
  12. 12.
    Esco R, Palacios A, Pardo J, Biete A, Carceller JA, Veiras C, et al. Infrastructure of radiotherapy in Spain: a minimal standard of radiotherapy resources. Int J Radiat Oncol Biol Phys. 2003;56(2):319–27.PubMedCrossRefGoogle Scholar
  13. 13.
    Larrañaga N, Galceran J, Ardanaz E, Franch P, Sánchez MJ, Pastor-Barriuso R, et al. Prostate cancer incidence trends in Spain before and during the prostate-specific antigen era: impact on mortality. Ann Oncol. 2010;21(Suppl 3):iii83–9.Google Scholar
  14. 14.
    Guedea F, Venselaar J, Hoskin P, Hellebust TP, Peiffert D, Londres B, et al. Patterns of care for brachytherapy in Europe: updated results. Radiother Oncol. 2010;97(3):514–20.PubMedCrossRefGoogle Scholar
  15. 15.
    Ruggieri-Pignon S, Pignon T, Marty M, Rodde-Dunet MH, Destembert B, Fritsch B. Infrastructure of radiation oncology in France: a large survey of evolution of external beam radiotherapy practice. Int J Radiat Oncol Biol Phys. 2005;61(2):507–16.PubMedCrossRefGoogle Scholar
  16. 16.
    Jetne V, Kvaløy S, Smeland S, Johannesen TB, Tveit KM. Use of radiotherapy in South-Eastern Norway Regional Health Authority. Tidsskr Nor Laegeforen. 2009 17;129(24):2602–5.Google Scholar
  17. 17.
    Ringborg U, Bergqvist D, Brorsson B, Cavallin-Ståhl E, Ceberg J, Einhorn N, et al. The Swedish Council on Technology Assessment in Health Care (SBU) systematic overview of radiotherapy for cancer including a prospective survey of radiotherapy practice in Sweden 2001—summary and conclusions. Acta Oncol. 2003;42(5–6):357–65.PubMedCrossRefGoogle Scholar
  18. 18.
    Delaney GP, Jacob S, Featherstone C, Barton M. Radiotherapy in cancer care: estimating optimal utilisation from a review of evidence-based clinical guidelines. Collaboration for Cancer Outcomes Research and Evaluation (CCORE). Liverpool Hospital; Sydney; 2003.Google Scholar
  19. 19.
    Tyldesley S, Delaney G, Foroudi F, Barbera L, Kerba M, Mackillop W. Estimating the need for radiotherapy for patients with prostate, breast, and lung cancers: verification of model estimates of need with radiotherapy utilization data from British Columbia. Int J Radiat Oncol Biol Phys. 2011;79(5):1507–15.PubMedCrossRefGoogle Scholar
  20. 20.
    Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, et al. Cancer incidence in five continents, Vol. IX. IARC Scientific Publications No 160, Lyon: IARC, 2007 Board of the Faculty of Clinical Oncology. Equipment, workload and staffing for radiotherapy in the UK 1997–2002. London: The Royal College of Radiologists; 2003.Google Scholar

Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2013

Authors and Affiliations

  • J. López Torrecilla
    • 1
    Email author
  • A. Zapatero
    • 2
  • I. Herruzo
    • 3
  • F. A. Calvo
    • 4
  • M. A. Cabeza
    • 5
  • A. Palacios
    • 6
  • A. Guerrero
    • 7
  • A. Hervás
    • 8
  • P. Lara
    • 9
  • B. Ludeña Martínez
    • 10
  • E. del Cerro Peñalver
    • 11
  • G. Nagore
    • 12
  • G. Sancho
    • 13
  • J. L. Mengual
    • 14
  • M. Mira
    • 15
  • A. Mairiño
    • 16
  • P. Samper
    • 17
  • S. Pérez
    • 18
  • I. Castillo
    • 19
  • J. C. Martínez Cedrés
    • 20
  • E. Ferrer
    • 21
  • S. Rodriguez
    • 22
  • X. Maldonado
    • 23
  • A. Gómez Caamaño
    • 24
  • C. Ferrer
    • 25
  • On behalf of the Grupo de Investigación GICOR-URONCOR-SEOR
  1. 1.Department of Radiation Oncology-ERESAHospital General UniversitarioValenciaSpain
  2. 2.Department of Radiation OncologyHospital Universitario de la PrincesaMadridSpain
  3. 3.Department of Radiation OncologyHospital Universitario Carlos HayaMálagaSpain
  4. 4.Department of OncologyHospital Universitario Gregorio MarañónMadridSpain
  5. 5.Hospital Universitario 12 de OctubreMadridSpain
  6. 6.Hospital Universitario Reina SofíaCórdobaSpain
  7. 7.Hospital Universitari Son DuretaPalmaSpain
  8. 8.Hospital Universitario Ramón y CajalMadridSpain
  9. 9.Hospital Universitario de Gran Canaria Dr. NegrínLas Palmas de Gran CanariaSpain
  10. 10.Hospital Universitario de FuenlabradaFuenlabradaSpain
  11. 11.Hospital Quirón de MadridMadridSpain
  12. 12.Instituto Alicantino de Oncología-Grupo IMOSanatorio del Perpetuo SocorroAlicanteSpain
  13. 13.Hospital de la Santa Creu i Sant PauBarcelonaSpain
  14. 14.Instituto Valenciano de OncologíaValenciaSpain
  15. 15.Hospital Universitari Arnau de VilanovaLleidaSpain
  16. 16.Centro Oncológico de Galicia, Complejo Hospitalario Universitario de A CoruñaA CoruñaSpain
  17. 17.Hospital Central de la Defensa “Gómez Ulla”MadridSpain
  18. 18.Hospital Marqués de ValdecillaSantanderSpain
  19. 19.Hospital Clínico Universitario San CecilioGranadaSpain
  20. 20.Hospital Universitario Nuestra Señora de la CandelariaSanta Cruz de TenerifeSpain
  21. 21.Hospital Clínico Universitario de ValenciaValenciaSpain
  22. 22.Hospital Clínica BenidormBenidormSpain
  23. 23.Hospital Vall D’HebronBarcelonaSpain
  24. 24.Hospital Clínico Universitario de Santiago de CompostelaSantiago de CompostelaSpain
  25. 25.Consorcio Hospitalario Provincial de CastellónCastellónSpain

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