S1426
Interdisciplinary - Health economics & health services research
ESTRO 2026
Hedwig Blommestein 16 , Paula Lorgelly 17 , Lone Hoffmann 5,2 1 Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark. 2 Department of Clinical Medicine, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark. 3 Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven– University of Leuven, Leuven, Belgium. 4 Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium. 5 Department of Oncology and Medical physics, Aarhus University Hospital, Aarhus, Denmark. 6 Department of Oncology, Rigshospitalet, Technical University Hospital of Greater Copenhagen, Copenhagen, Denmark. 7 Department of Thoracic Surgery,, University Hospitals Leuven, Leuven, Belgium. 8 Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. 9 Department of Medical Physics and Biomedical Engineering, Department of Medical Physics and University College London, London, United Kingdom. 10 OncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. 11 Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. 12 Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, Netherlands. 13 Research Dept. of Primary Care and Population Health,, ResearcUniversity College London,, London, United Kingdom. 14 Center for Proton Therapy, Paul Scherrer Institut, Villigen, Switzerland. 15 Radiation Oncology Department, University Hospital Zurich, Zurich, Switzerland. 16 Erasmus School of Health Policy and Management, Erasmus School of HealErasmus University Rotterdam, Rotterdam, Netherlands. 17 University of Auckland,, Waipara Taumata Rau, Auckland, New Zealand Purpose/Objective: International, multicenter radiotherapy trials require a solid study plan, including a quality assurance strategy, to maximize chance of high-quality results. The current objective was to identify key elements for future trials, enabling researchers to identify challenges and opportunities, ensuring answers to each research question and inform evidence-based change(s) in health service policy and clinical practice. In this study, a framework is provided using the PROTECT trial as an example[1]. Material/Methods: The international phase III randomized PROTECT trial is being conducted in a European consortium. Comprehensive details of all study aspects were
Conclusion: Hypofractionated radiotherapy achieved a 33% cost reduction and a 32% decrease in total CO ₂ emissions, including a 49% cut in transport-related emissions. Beyond economic efficiency, these results emphasize hypofractionation as a key strategy for delivering high- value, low-carbon cancer care in resource-limited settings. Keywords: Carbon-foot-ptint, Hypofractionation, LMIC Designing an international multicenter clinical radiotherapy trial – experience from the PROTECT trial (NCT050555648). Hanna Rahbek Mortensen 1,2 , Karin Haustermans 3,4 , Marianne Nordsmark 5 , Camilla Skinnerup Byskov 5 , Cai Grau 1 , M Lykkegaard Ehmsen 1 , Pieter Populaire 3,4 , Ditte Sloth Møller 5,2 , Ane Appelt 6 , Phillippe Nafteux 7 , Christina T Muijs 8 , Maria A Hawkins 9 , Esther GC Troost 10,11 , Gilles Defraene 3 , Richard Canters 12 , Eric W Korevaar 8 , Caroline S Clarke 13 , Damien C Weber 14,15 , Digital Poster 4135
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