S1298
Clinical - Urology
ESTRO 2026
with a 61% reduction in CO2e emission compared to twenty fractions (from 235 kg to 93 kg CO2e). Another mitigation strategy would include using an energy mix based on renewable resources only, which would reduce MR-Linac impact with 63%.
Digital Poster 4423
Carbon footprint of prostate cancer radiotherapy: a comparison between different radiotherapy
modalities using life cycle assessment Casper UM Reijnen 1 , Sifra Eigenraam 2 , Juli
Muijderman 3 , Michiel J. Sedelaar 4 , Hugo R.W. Touw 2 , Robert Jan Chuter 5 , Tim Stobernack 2 , Erik van der Bijl 1 1 Radiation Oncology, Radboud university medical center, Nijmegen, Netherlands. 2 Intensive Care Medicine, Radboud university medical center, Nijmegen, Netherlands. 3 Centre for Sustainable Healthcare, Amsterdam university medical center, Amsterdam, Netherlands. 4 Urology, Radboud university medical center, Nijmegen, Netherlands. 5 Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, United Kingdom Purpose/Objective: Climate change due to greenhouse gas emission is a major global problem and healthcare systems contribute about 5% of these emissions. Prostate cancer is one of the most prevalent oncological diagnoses and its treatment therefore contributes significantly to the total. In this study we compare the carbon footprint of two different radiotherapy regimens for low- to intermediate risk prostate cancer patients using a structured life cycle assessment (LCA) methodology. Material/Methods: We have performed a LCA for mildly hypofractionated external beam radiotherapy (EBRT) on the CBCT-Linac in twenty fractions and hypofractionated EBRT on the MR-Linac in five fractions. For these care paths a structured analysis was performed for all factors contributing to climate change, including direct energy consumption; patient and staff travel; heating, ventilation and air conditioning; disposables and medication use. Data was collected using questionnaires, waste audits, direct measurements of energy use and retrospective record analysis. Results: In total, hypofractionated five-fraction radiotherapy on the MR-Linac was associated with 293 kg CO2 equivalent (CO2e) and twenty-fraction radiotherapy on the CBCT-Linac was associated with 277 kg CO2e (Figure 1). In the five-fraction MR-Linac regime, treatment-unit energy consumption (including idle time and magnet cooling) accounted for 54% of total CO ₂ -eq, inclduing direct energy use during treatment, supporting infrastructure, and overhead energy use (idle time, and energy use of magnet cooling). In the twenty-fraction EBRT, patient transport contributed most to the total CO2e emission (80%). Simulation of the impact of a five-fraction hypofractionated scheme on the CBCT-Linac showed this treatment is associated
Conclusion: Since patient travel is the dominant contributor to emissions in radiotherapy, five fraction treatments are preferable from this point of view, when possible on CBCT-Linacs which also have a significantly lower direct energy usage. Keywords: prostate cancer, carbon footprint Poster Discussion 4509 Phase 1 Study of Localized Antiandrogen Therapy Using Biolen® (Bicalutamide) Implants with Radiotherapy for Localized Prostate Cancer Deborah E Citrin 1 , Baris Turkbey 2 , Peter Choyke 2 , Peter Pinto 3 , Bradford Wood 4 , Krishnan Patel 5 , Pujan Desai 6 , Sandeep Gurram 3 , Scott Thomas 6 , Maithili Rairkar 6 , Pamela Munster 6,7 1 Radiation Oncology Branch, NCI, Bethesda, USA. 2 Molecular Imaging Branch, NCI, Bethesda, USA. 3 Urologic Oncology Branch, NCI, Bethesda, USA. 4 Interventional Radiology, NCI, Bethesda, USA. 5 Radiation oncology Branch, NCI, Bethesda, USA. 6 Alessa Therapeutics, Alessa Therapeutics, San Carlos, USA. 7 Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, USA Purpose/Objective: Systemic androgen deprivation therapy (ADT) is an integral part of therapy for unfavorable intermediate or high-risk prostate cancer treated with radiation therapy (RT). However, systemic anti-androgens are associated with considerable cardiovascular, metabolic, and sexual side effects leading to omission in many men. We tested the feasibility of replacing systemic ADT with targeted local delivery of an anti- androgen agent (bicalutamide, Biolen® Implant) designed to provide sustained anti-androgen administration selectively to prostate tumors. Material/Methods:
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