A 60-year-old woman visited our hospital, complaining of hyperpigmentation and itching of the skin. The case was histologically diagnosed as acanthosis nigricans by skin biopsies. It is usually associated with malignancies, of which gastric cancer is by far the most common. Upper endoscopy revealed advanced gastric cancer (Borrmann type 3). Total gastrectomy was performed, but the patient died of peritonitis carcinomatosa 21 months after resection. It is important to examine the upper GI tract periodically when acanthosis nigricans is present from the early stage.

　　The Tsurumi Hospital introduced a state-of-the-art, multifunctional cancer radiation therapy system in April 2011. When a new building was completed. The cancer radiation therapy started in September of the same year. Our hospital as a cancer treatment hospital provides high-quality care, and can deliver radiation therapy of high performance and high precision in safety, and aims to be trusted by society and patients. In a cancer radiation therapy, it is important to work in teams made up of doctors, radiological technologists and nurses having a high degree of professionalism. In such circumstances radiological technologists have to play various roles and shoulder responsibility. For example, they have to take responsibility for dose distribution creation and calculation of monitor units according treatment plans, systems, positioning radiography, creating a fixture and immobilizer, verification of irradiation, setup of patient, quality assurance and quality control of related equipment for the radiotherapy system, explanation to the patient, medical safety and radiation maintenances etc. Since the introduction of the cancer radiation therapy system, radiological technologists have had to carry out work required for radiation therapy such as verification of creating specifications, determination of equipment, procedures based on the relevant laws and regulations, acceptance test, acquisition of clinical data, commissioning and verification of treatment dose. This paper describes the role and practice of radiological technologists to lead a cancer radiation therapy, based upon our experience.