Quantifying non-clinical outcomes of ultra-hypofractionated breast radiotherapy in Western NSW-A narrative review

Ultra-Hypofractionated Whole Breast Radiotherapy (U-WBRT) has been proven to be a viable treatment option for breast cancer patients receiving radiation therapy, however, due to its novelty our understanding of its non-clinical benefits is still evolving. With increasing U-WBRT selection during COVID and in rural and regional settings such as the Western New South Wales Local Health District (WNSWLHD), it's important to quantify the savings when compared to other fractionation schedules (e.g. Conventional fractionation (C-WBRT) involving 25 fractions and Moderate hypofractionation (M-WBRT) with 15 fractions.) Using literature sourced from Medline, Embase, Pubmed and reports from relevant websites and organisations this narrative review investigates quantifiable methods of assessing non-clinical benefits of U-WBRT in rural settings according to the triple bottom line philosophy. This review was able to identify a standard set of quantifiable metrics that can compare the non-clinical benefits of various fractionation schedules, with relevance to a rural setting. These include: fractionation trends, financial subsidy, average linear accelerator (Linac) minutes, hospital visits, travel time and distance, Linac energy consumption, travel and Linac carbon emissions. By identifying these metrics, non-clinical benefits between the fractionation schedules can easily be quantified and compared.