ESTRO 2025 - Abstract Book

S2246

Interdisciplinary – Global health

ESTRO 2025

Conclusion: Reducing the CO2e emissions due to radiotherapy is possible via hypofractionation but only radical overhaul of schedules leads to significant reductions. But, mild hypofractionation combined with other emission reduction approaches could be a feasible way forward.

Keywords: CO2 emissions, Hypofractionation, LCA

References: 1 Bhatia et al. BMJ 2024 386, 079072

2 Lichter et al. Lancet Oncol. 2024 25,790-801 3 Kaas et al. Radiother. Oncol. 2025 202, 110601

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Digital Poster ESTRO’s initiative defining a minimum set of radiotherapy-specific Quality Indicators through the National Societies Committee Cristina Garibaldi 1 , Aude Vaandering 2 , Amanda Cassie 3 , Gianfranco Brusadin 4 , Pierfrancesco Franco 5,6 , Valérie Cremades 7 , Barbara A. Jereczek-Fossa 8,9 , Nuria Jornet 10 1 Unit of Radiation Research, IEO-European Institute of Oncology, IRCCS, Milan, Italy. 2 Department of Radiation Oncology, Cliniques Universitaires St Luc, Brussels, Belgium. 3 Dept. of Radiation Oncology, Dalhousie University, Halifax, Canada. 4 Department of Quality and Risk Management, Gustave Roussy, Paris, France. 5 Department of Translational Medicine (DIMET), University of Eastern Piedmont, Novara, Italy. 6 Department of Radiation Oncology, 'Maggiore della Carità' University Hospital, Novara, Italy. 7 ESTRO, European Society of Radiation Oncology, Brussels, Belgium. 8 Dept. of Oncology and Hemato-oncology, University of Milan, Milan, Italy. 9 Dept. of Radiation Oncology, IEO-European Institute of Oncology, IRCCS, Milan, Italy. 10 Servei de Radiofisica i Radioprotecció, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain Purpose/Objective: Ensuring equitable access to modern radiotherapy requires consistent treatment quality across centers. Robust Quality Indicators (QIs) are crucial for evaluating adherence to standards and identifying areas for improvement. Currently no standardized European QI set exists; however, individual countries have created their own lists. To bridge this gap, our goal was to establish a consensus on a core set of QIs, which would enable benchmarking and promote continuous quality improvement in radiotherapy services across Europe. Material/Methods: We performed a comprehensive literature review in Embase database, covering publications from January 2010 to March 2021, to identify existing QIs in radiotherapy. The identified QIs were categorized according to the Donabedian model into structure, process, or outcome measures. A multidisciplinary core group—including radiation oncologists, medical physics experts, radiation therapists, and quality managers—developed an initial list of QIs based on the review findings. Through Delphi process this list was distributed to experts from each National Society (NS) for evaluation. QI were assessed on four parameters: importance, scientific validity, benchmarking utility, and ease of data collection. QIs with the highest scores were prioritized for further consideration. Definitions of several QIs were refined to enhance clarity and understanding. Despite high scores, we excluded QIs that were site-specific or directly related to the capabilities and workload of individual Radiation Oncology departments to focus on universally applicable QIs. Results: Our comprehensive literature review identified 827 QIs across 106 selected papers, categorized as structural (16%), process-related (70%), and outcome-based (14%) QIs. The core group distilled these into 114 potential key QIs,