Half Beam Block Technique in Breast Cancer and It's Dosimetric Analysis using different Algorithms

Single isocentre half-beam block (HBB) technique permits the avoidance of hot and cold spots. This technique is very useful in sparing the underlying ipsilateral lung and heart, if the left breast is treated. The major advantage of this technique is that it facilitates the complete sparing of both contralateral breast and lung. Regarding this, the present study aimed to analyse the dosimetric results obtained from the HBB technique in the treatment of breast cancer using three different algorithms.
For the purpose of the study, a total dose of 5000 cGy was prescribed to the planning target volume (PTV) in 25 fractions per fraction daily, five days a week. The PTV was derived by using 4-7 mm isotropic expansion of the clinical target volume (CTV) clipping 1-3 mm from the patient’s surface in the breast-conserving cases. Three plans were created for each patient using three different algorithms, including convolution, fast superposition, and superposition with the same parameters.
The mean doses of PTV-breast and CTV-supraclavicular fossa (SCF) were tabulated and analysed. In the PTV-breast, the maximum and minimum mean doses were 5428.8 and 4930.2 cGy, which were observed in the fast superposition and convolution algorithms, respectively. In the CTV-SCF, the maximum and minimum mean doses were 5428.8 and 5126.8 cGy, respectively, detected in only fast superposition algorithm.
As the findings of the present study indicated, the convolution algorithm gives slightly better dosimetric results in breast cancer treatment, compared to the fast superposition and superposition algorithms. Therefore, it is prudent to apply the HBB technique with convolution algorithm using the Elekta XiO planning system in the treatment of breast cancer including supraclavicular lymph node metastasis.