ESTRO's principles for environmental sustainability in the radiation oncology community

Climate change, pollution, and resource depletion pose significant challenges to modern society, including the healthcare sector. While the delivery of health services inherently entails energy and resource utilization, the health care sector has a relevant role to play for sustainable development, since it is estimated to account for approximately 4.7% of total greenhouse gas emissions in the EU whilst also contributing to natural resource depletion, toxic chemical release, and the generation of non-compostable waste. In response, the European Society for Radiotherapy and Oncology (ESTRO) established the Green Task Force in 2022 to support the development of a strategic framework, which integrates environmental sustainability into ESTRO's activities. This position paper presents ESTRO's principles for environmental sustainability, which focus on four key areas: (1) raising awareness and sharing best practices, (2) monitoring the environmental impact of ESTRO's activities, (3) evaluating interventions to reduce carbon emissions and improve the environmental sustainability of ESTRO activities, and (4) embedding sustainability into governance and professional activities. Examples of strategies which can reduce climate impact of ESTRO activities include advocating for environmentally conscious radiotherapy practices, considering venues that facilitate shorter travelling for participants in ESTRO conferences and educational activities, promoting digital participation, facilitating sustainable travel options and promoting healthy lifestyle. By emphasizing sustainability, ESTRO aims to lead the radiation oncology community toward a more environmentally responsible future, balancing scientific progress with climate-conscious practices. This initiative aligns with global sustainability goals and underscores the role of oncology professionals in addressing the climate crisis.