Global greenhouse gas emissions from external beam radiotherapy: a population-based study
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Published on: July 3, 2014
Hongcheng Zhu1, Icro Meattini2, Lixiao Zhang3
1Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Clinical Research Center for Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.
Purpose:
To assess the global and country-level greenhouse gas emissions implications of external beam radiotherapy (EBRT) scale-up to 2050.
Methods And Materials:
We conducted a country-level, scenario-based study across 181 countries to estimate EBRT-associated greenhouse gas emissions in 2022 and project emissions to 2050 under utilisation benchmarks of 50% and 64%, uniform schedules of 25, 15, and 5 fractions per course, and prespecified income-stratified Moderate and Ambitious hypofractionation pathways. Country-specific utilisation was examined as an access-constrained sensitivity scenario.
Results:
Across all scenarios, global EBRT-associated emissions increased from 2022 to 2050. With 25-fraction delivery, emissions rose from 43.02 to 67.94 MtCO2e under the 50% utilisation and from 55.06 to 86.96 MtCO2e under the 64% utilisation. Under the 50% benchmark, 15- and 5-fraction schedules reduced 2050 emissions to 40.76 and 13.59 MtCO2e, respectively. Emissions shifted towards middle-income settings: the high-income share declined from 42.9% to 36.5%, while the 10 countries with the largest modelled EBRT-associated emissions still accounted for 64.5% of global emissions in 2022 and 60.6% in 2050. Compared with a uniform 25-fraction baseline, the Moderate pathway reduced global emissions by 23.3% in 2022 and 21.9% in 2050, while the Ambitious pathway reduced emissions by 36.5% and 34.7%, respectively. The largest absolute reductions occurred in high-income and upper-middle-income settings.
Conclusion:
Global EBRT-associated emissions are projected to rise substantially by 2050. Clinically appropriate hypofractionation offers a high-leverage mitigation opportunity, with priorities differing between decarbonising established high-volume systems and embedding low-carbon delivery during capacity expansion.
