Background: The demand for palliative care in Japan has risen over recent years, and training of palliative care physicians is an important problem. However, little is known about unmet needs for education and training systems as well as career development among young physicians who wish to specialize in palliative care. Purpose: To explore unmet needs among palliative care physicians in training. Method: We held group discussions in a forum for physicians of postgraduate year≦15, and analyzed their opinion on topics such as "what are unmet needs?" using theme analysis. Results: Forty physicians participated. Theme analysis revealed the following unmet needs among young physicians; "securing of manpower", "securing of quality of training programs/education", "improvement of network", "removal of many barriers to keeping on a palliative care physician", and "establishment of career models for a specialist". Conclusions: We should discuss solutions for the unmet needs to secure more palliative care physicians.

A new radiation system known as the TomoTherapy Radixact X9 was introduced at our hospital in June 2021. From August 2021 to March 2022, 6 patients underwent total body irradiation (TBI) with tomotherapy with the Radixact X9. This paper describes the sequence of events from treatment planning computed tomography to irradiation. Results are also reported for measurements made with Gafchromic EBT3 film, the Delta4 Phantom+, and an A1SL ionization chamber dosimeter, set-up error, and time required to enter and exit the room, which were measured during plan verification. The measurement results were as follows: Gafchromic EBT3 film, 91.78±0.96% ; Delta4 Phantom+ head, 100±0% ; chest, 98.93±1.17% ; foot, 98.90±2.28% ; ionization chamber dosimeter A1SL, -0.39±0.70%; Residual error: -0.01±1.91 mm for lateral, 0.29±1.60 mm for longitudinal, 0.36±2.07 mm for vertical, -0.06±0.78° for roll. In addition, the time required to enter and exit the room was 98.50±17.17 min. TBI could be performed within set-up error of 5 mm in all cases. The validation results from the initial 6 cases confirmed that TBI with tomotherapy provided good dose distribution and positional accuracy.