28 Travel time and carbon footprint of patients accessing stereotactic radiosurgery for intracranial metastatic disease from South West Wales

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Abstract Introduction At present, all oncology patients from South West Wales Cancer Centre (SWWCC) who require stereotactic radiosurgery (SRS) are treated approximately 74km away in Velindre Cancer Centre (VCC) in Cardiff. Research by The Tessa Jowell Academy SRS working group highlighted the wide variation in access to SRS for patients and risk of inequity. We analysed travel time and the potential environmental impact of the current SRS service. Method Data was retrospectively collected on all SWWCC patients who had undergone SRS at VCC between January 2020 and January 2026. Travel distances, times and carbon emissions were calculated using RTInsight, a Python-based geospatial analysis tool developed at SWWCC. Results A total of 103 SRS treatments were delivered to 89 patients. 90% (80) of patients were treated with a single fraction, between 15 Gray(Gy) up to 21Gy, with 21Gy in one fraction being the most common. The median distance to SWWCC for patients was 20km compared to 74km to VCC with the maximum distance a patient travelled in a single journey being 203km. This equated to a median travel time to SWWCC of 29 minutes compared to 66 minutes for a single journey to VCC. Patients attend VCC at least three times during their treatment pathway, equating to a total travel time of around 7 hours. The median carbon emissions for a return journey to VCC was 25.74 kgCO2e compared to median carbon emissions to SWWCC of 6.88 kgCO2e. The median carbon emissions for attending VCC for review, planning and treatment was 77.22 kgCO2e compared with 20.64 kgCO2e if able to treat locally. Conclusion Future remodelling of the SRS service is required to reduce the travel burden for patients and improve environmental sustainability.