S1381
Interdisciplinary - Health economics & health services research
ESTRO 2026
University Hospital Arnau de Vilanova (Lleida) were analyzed. The study quantified patient travel distance, transportation costs, and CO ₂ emissions based on each fractionation scheme. Geographic distribution, travel routes, and transport tariffs from the public healthcare system were used to estimate costs and emissions. Clinical equivalence between regimens was confirmed from published randomized trials. Results: The 5-fraction schedule reduced the median travel distance from 926.4 km to 308.8 km per patient, representing a 66.7% reduction (617.6 km saved). The median transportation cost decreased from € 657.8 to € 219.3, with an average saving of € 438.5 per patient, equivalent to € 251,699 in total savings for the study cohort. In environmental terms, CO ₂ emissions dropped from 117.5 kg to 39.2 kg per patient, resulting in a reduction of 78.3 kg per patient and an estimated 44.9 tons of CO ₂ avoided across the treated population. Beyond economic and ecological gains, the 5-fraction scheme reduced time spent traveling and hospital visits, improving quality of life, treatment accessibility, and patient satisfaction, particularly for those living in rural areas (54% of the cohort).
Conclusion: Ultra-hypofractionated radiotherapy for breast cancer demonstrates equivalent clinical efficacy while achieving significant sustainability benefits. The regimen provides measurable reductions in transportation costs, CO ₂ emissions, and logistical burden for both patients and the healthcare system. This model exemplifies triple sustainability— economic, environmental, and social—aligning with the Green Hospital framework and the UN 2030 Sustainable Development Goals. Implementing 5- fraction protocols as the standard of care for eligible patients represents not only a clinical improvement but also a systemic innovation that enhances equity, efficiency, and environmental responsibility in modern radiotherapy services. References: Brunt AM, et al. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. Lancet. 2020;395(10237):1613–1626.Health Care Without Harm.Health care’s climate footprint: How the health sector contributes to the global climate crisis and opportunities for action. Brussels: Health Care Without Harm; 2019Ministerio de Sanidad. Huella climática del sector salud en España. Gobierno de España; 2023. Keywords: Carbon footprint, Health economics, Hypofraction Digital Poster Highlight 628 Understanding Barriers to Patient Participation in Radiotherapy Clinical Trials: A Real-World Institutional Analysis Karen Molan 1 , Erica Bennett 1 , Mohd Syafawi Mat Samuji 1 , Ita-Marie Dunne 2 , Kathy Rock 1 , Orla Houlihan 3 , Paul Kelly 1 1 Radiotherapy, Bon Secours Radiotherapy Cork in partnership with UPMC Hilman Cancer Centre, Cork, Ireland. 2 Radiotherapy, Whitfield Hilman Cancer Centre, Waterford, Ireland. 3 Radiotherapy, Department
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