S1412
Interdisciplinary - Health economics & health services research
ESTRO 2026
on NRRP resources for procurement (56% vs. 40%). Baseline technology strongly correlated with demand: low-tech centers expressed the highest needs (e.g., 4D imaging in 89%), while high-tech centers had lower needs (47%), but still benefited substantially, with NRRP covering ~85% of new linacs and all in vivo systems. Conclusion: NRRP funding has substantially accelerated the technological advancement of SBRT in Italy’s public radiotherapy centers. By addressing critical technological gaps, particularly in less-experienced or lower-resourced centers, NRRP enhanced equity between centers, and promoted more uniform and up-to-date access to advanced SBRT technologies nationwide. Keywords: EU funding, advanced radiotherapy technology, SBRT Digital Poster 3044 Decarbonising external-beam radiotherapy: measured CO ₂ e across the workflow, cross-centre comparison and actionable mitigations Hsiu-Wen Hsiao 1 , Yu-Jen Wang 1,2 1 Radiation Oncology, Fu Jen Catholic University Hospital, New Taipei City, Taiwan. 2 Medicine, Fu Jen Catholic University, New Taipei City, Taiwan Purpose/Objective: To quantify the carbon footprint (CO ₂ e) of external- beam radiotherapy (EBRT) across the end - to - end workflow at a tertiary radiation oncology centre, and compare findings with published datasets from a US academic centre and the UK (multicentre). The study aims to identify dominant emission sources and explore feasible mitigation strategies for carbon reduction in radiotherapy practice. Material/Methods: A process-based carbon audit was conducted encompassing computed tomography simulation (CT- sim), linear accelerator (Linac), and patient transportation. Electrical consumption was measured and converted to CO ₂ e using standard emission factors. Patient commuting distances and mode of transportation were obtained via anoymised surveys and converted with standard vehicle emission factors. Four treatment sites—breast, prostate, lung and rectal—were analyzed. Hypofractionated breast schedules were compared with a published UK multicentre dataset and short- versus long-course schedules for lung and rectal cancers were contrasted with a US academic cohort.IRB approval obtained; informed consent waived for anonymised data. Results: Department - level emission contributions were: Linac
Figure 1 and 2 summarize the results.
High-SBRT-volume centers reported lower needs for SGRT (55% vs. 79% among low-volume centers), reflecting greater baseline availability. Nevertheless, NRRP funding supported new SGRT implementation at similar rates across both groups (~60% of acquisitions). Less-experienced centers expressed greater demand for 4D imaging/respiratory management (81% vs. 61%) and greater dependence
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