S1413
Interdisciplinary - Health economics & health services research
ESTRO 2026
standby 65.3%, CT-sim standby 12.1%, Linac treatment 5.4%, CT-sim scanning 1.8%, and patient transport 16.9% (Fig. 1). Per-patient totals throughout the EBRT were 116.8 kg (breast conventional), 74.6 kg (breast hypofractionated), 175.4 kg (prostate conventional), hypofractionation. For hypofractionated breast, mean CO ₂ e per patient was 74.6 kg versus 101.8 kg in a UK multicentre report, with source contributions differing markedly—travel by car 27.2% versus ~82%, and Linac idle time 56.3% versus ~10%—consistent with shorter local travel distances (~3.9 km vs ~30 km) and greater use of two-wheel transport (Fig. 1). Locally, the modal split was: car 29.9%, motorcycle/scooter 51.7% and public transport 18.4% (n = 114). Shifting from car to public transport reduced travel-related CO ₂ e(kg) about five-fold locally (about six-fold in the UK dataset).In Linac treatment delivery, short-course lung and rectal and 122.5 kg (prostate hypofractionated), demonstrating 30-36% reductions with schedules resulted in lower emissions than long- course schedules (Table 1). The differences in carbon emissions per treatment course for lung and rectal patients across centres may reflect variations in accelerator models or energy efficiency, as well as differences in treatment planning parameters such as field size, beam energy, and treatment technique.
Conclusion: Standby power and patient transport dominate EBRT - related CO ₂ e. Hypofractionation, standby energy management, and modal shifts to public transport (e.g., shuttle services) are high - yield, immediately actionable levers. Routine carbon auditing can guide procurement and scheduling policies that advance environmentally sustainable radiotherapy. References: 1. Shenker RF et al. Adv Radiat Oncol. 2023; 8: 101170.2. Chuter RW et al. Phys Med. 2023; 112: 102652. Keywords: Carbon footprint, Hypofractionation,Sustainability Digital Poster Highlight 3087 From data to value: implementing VBHC in radiotherapy to improve outcomes and strengthen strategy Paul Cremers 1 , Malou Kuppen 1 , Evert van Limbergen 1 , Pascale Simons 1 , Maria Jacobs 1,2 , Ingrid Kremer 1 1 Department of Radiation Oncology, Maastro, Maastricht, Netherlands. 2 Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands Purpose/Objective: Value-Based Health Care (VBHC) offers a compelling framework for improving patient outcomes relative to costs. However, translating this theory into daily clinical practice remains challenging. We developed and implemented a structured, practice-oriented approach to VBHC tailored to radiotherapy. This abstract evaluates the practical challenges encountered during implementation. Material/Methods: VBHC was implemented through a bottom-up, clinician-led approach, aligned with Porter’s value agenda. Our care is organized into tumor-specific Integrated Practice Units. Teams define outcomes based on ICHOM standards, such as survival and
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