[Survey of radiotherapy resource allocation and service capacity in Hunan Province, 2025]

Radiotherapy is one of the most important treatment modalities for malignant tumors, with 60% to 70% of cancer patients requiring radiotherapy during the course of their disease. This study aims to comprehensively investigate and analyze the current status of radiotherapy in Hunan Province in 2025, providing evidence for optimizing the allocation of radiotherapy resources, enhancing oncology service capacity, and improving the regional radiotherapy system across the province.

Based on the standardized radiation therapy basic information survey form developed by the Hunan Provincial Medical Quality Control Center for Cancer Diagnosis and Treatment, a combined approach of online data submission and offline verification was used to conduct a survey among medical institutions in Hunan Province providing radiation therapy services. Data were collected through a combination of online reporting and on-site verification. Survey items included institutional characteristics, workforce allocation, radiotherapy equipment and auxiliary facilities, implementation of radiotherapy technologies, patient volume, and quality control system development. The survey was conducted from July to September 2025 under the coordination of municipal cancer diagnosis and treatment quality control centers. After data collation and verification, the authenticity of the reported information was further validated through random on-site inspections conducted by the Hunan Provincial Quality Control Center for Cancer Diagnosis and Treatment.

As of September 2025, Hunan Province had 90 radiotherapy institutions, representing an increase of 14 institutions compared with 2022. Among them, 70 (77.78%) were tertiary hospitals and 74 (82.22%) were public hospitals, which remained the major service providers of radiotherapy services. The proportion of annual radiotherapy patients treated in non-capital-city hospitals increased from 26.5% to 29.3%. A total of 2 057 radiotherapy professionals were employed province-wide, including 889 physicians, 231 medical physicists, 433 radiation therapists, 444 nurses, and 60 engineers, yielding a physician-to-physicist ratio of 3.8꞉1. In terms of equipment, there were 127 external beam radiotherapy units, including 115 medical accelerators (of which 4 were Tomotherapy [TOMO] systems) and 12 Gamma Knife units, as well as 33 brachytherapy afterloading systems. Auxiliary equipment included 85 simulation units, 210 treatment planning systems, 199 dosimeters, and 114 verification systems. Compared with 2022, the numbers of linear accelerators, CT simulators, and dose verification devices increased by 30.59%, 61.54%, and 93.22%, respectively. The province achieved 1.73 linear accelerators per million population, although regional disparities in resource distribution persisted. The proportion of domestically manufactured linear accelerators increased from 10.22% in 2022 to 14.41% in 2025. Regarding radiotherapy technologies, a precision radiotherapy system centered on intensity-modulated radiation therapy (IMRT) had been established, with an IMRT implementation rate of 84.4%. Approximately 45% of radiotherapy institutions had adopted image-guided radiation therapy (IGRT), stereotactic body radiotherapy (SBRT), and respiratory motion management technologies. The annual number of patients receiving radiotherapy across the province reached approximately 48 000. The most common cancer types treated were lung cancer, breast cancer, cervical cancer, nasopharyngeal carcinoma, and rectal cancer, accounting for 60.11% of all radiotherapy cases. Following the implementation of Hunan Medical Insurance Policy [2025] No. 18, precision radiotherapy techniques, including IMRT, volumetric modulated arc therapy (VMAT), TOMO, and SBRT, were incorporated into the Category B reimbursement list of the provincial medical insurance program, substantially improving their accessibility and affordability.

The radiotherapy service capacity of Hunan Province improved substantially in 2025 compared with 2022, as evidenced by increases in the number of radiotherapy institutions and equipment, wider adoption of precision radiotherapy technologies, and further enhancement of quality control systems. A modern precision radiotherapy framework centered on IMRT has been largely established. Optimization of medical insurance reimbursement policies has further improved access to advanced radiotherapy technologies. Nevertheless, challenges remain, including unequal regional distribution of radiotherapy resources, suboptimal utilization efficiency of equipment in primary-level institutions, and shortages of highly qualified medical physicists. Future efforts should focus on strengthening regional coordination and resource allocation, enhancing radiotherapy capacity at the primary care level, improving the standardization of quality control practices, and promoting balanced development of the radiotherapy service system.