{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:14:35Z","timestamp":1782173675518,"version":"3.54.5"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["413668513"],"award-info":[{"award-number":["413668513"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Universit\u00e4tsklinikum Halle (Saale)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and objective<\/jats:title>\n            <jats:p>Radiotherapy often entails a\u00a0substantial travel burden for patients accessing radiation oncology centers. The total travel distance for such treatments is primarily influenced by two factors: fractionation schedules and the distances traveled. Specific data on these aspects are not well documented in Germany. This study aims to quantify the travel distances for routine breast cancer patients of five radiation oncology centers located in metropolitan, urban, and rural areas of Germany and to record the CO<jats:sub>2<\/jats:sub> emissions resulting from travel.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We analyzed the geographic data of breast cancer patients attending their radiotherapy treatments and calculated travelling distances using Google Maps. Carbon dioxide emissions were estimated assuming a\u00a0standard 40-miles-per-gallon petrol car emitting 0.168\u202fkg of CO<jats:sub>2<\/jats:sub> per kilometer.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Result<\/jats:title>\n            <jats:p>Addresses of 4198\u00a0breast cancer patients treated between 2018 and 2022 were analyzed. Our sample traveled an average of 37.2\u202fkm (minimum average: 14.2\u202fkm, maximum average: 58.3\u202fkm) for each radiation fraction. This yielded an estimated total of 6.2\u202fkg of CO<jats:sub>2<\/jats:sub> emissions per visit, resulting in 156.2\u202fkg of CO<jats:sub>2<\/jats:sub> emissions when assuming 25\u00a0visits (planning, treatment, and follow-up).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our study highlights the environmental consequences associated with patient commutes for external-beam radiotherapy, indicating that reducing the number of treatment fractions can notably decrease CO<jats:sub>2<\/jats:sub> emissions. Despite certain assumptions such as the mode of transport and possible inaccuracies in patient addresses, optimizing fractionation schedules not only reduces travel requirements but also achieves greater CO<jats:sub>2<\/jats:sub> reductions while keeping improved patient outcomes as the main focus.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00066-024-02303-w","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T12:02:03Z","timestamp":1727179323000},"page":"846-853","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Sustainability in radiation oncology: opportunities for enhancing patient care and reducing CO2 emissions in breast cancer radiotherapy at selected German centers"],"prefix":"10.1007","volume":"201","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5659-1485","authenticated-orcid":false,"given":"Ahmed","family":"Bedir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Grohmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Sch\u00e4fer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"M\u00e4urer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Weimann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Roers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Hering","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Oertel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Medenwald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Straube","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"issue":"26","key":"2303_CR1","doi-asserted-by":"publisher","first-page":"2913","DOI":"10.1200\/JCO.2014.55.1143","volume":"32","author":"ST Lutz","year":"2014","unstructured":"Lutz\u00a0ST, Jones\u00a0J, Chow\u00a0E (2014) Role of radiation therapy in palliative care of the patient with cancer. 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All data were processed anonymously. Only meta-data were pooled for the final analysis. All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}