Comparative Evaluation of Wedge and Field-in-Field Methods in Minimizing Brachial Plexus Radiation Dose in Breast Cancer Patients Undergoing Radiotherapy

Abstract

Background: Brachial plexopathy in breast cancer patients undergoing radiation therapy is an important side effect. The primary objective of this study was to compare the effectiveness and safety of two different treatment methods, the wedge method and field-in-field methods, in breast cancer patients undergoing radiotherapy. Specifically, the study aimed to evaluate the impact of these methods on the radiation dose received by the brachial plexus, a critical organ at risk in breast cancer treatment.

Methods: The study involved 100 breast cancer patients who underwent a series of 25 radiation therapy sessions. The total radiation dose administered throughout the therapy was 50 Gy, with each treatment session delivering 2 Gy. The study focused on measuring the radiation dose received by the brachial plexus. Two different methods, the wedge method, and the field-in-field process, were compared in terms of their ability to protect the brachial plexus from excessive radiation.

Results: The maximum dose delivered to the brachial plexus was 5302.18 cGy in the wedge group, and 5242.5 cGy in the field-in-field group. Although the field-in-field method appeared to be less risky, statistically there was no significant difference between the two methods (P > 0.05). Additionally, the mean dose delivered using the wedge method was 4169.98 cGy, while the field-in-field method had a mean dose of 4351.9 cGy and their difference was not statistically significant (P > 0.05).

Conclusion: The optimization of the treatment process is a crucial part of alleviating brachial plexopathy in breast cancer radiation therapy, and these dose measurements play a fundamental role in enhancing treatment protocols and improving patient comfort at the same time. It must be noted that even though the field-in-field technique decreased radiation exposure to the brachial plexus more than the wedge technique, further studies are still needed to determine the practical significance of these findings.