Analysis of anatomical parameters in the radiotherapy of breast cancer

Breast cancer is the most frequently diagnosed malignancy in women. At IRST Meldola, different radiotherapy techniques are used for breast cancer treatment, and the choice of the optimal approach is mainly based on clinicians’ experience. This study aims to identify anatomical parameters that can guide the a priori selection of the most suitable radiotherapy technique. Thirty patients with left breast cancer treated with 40.05 Gy in 15 fractions were retrospectively analyzed. For each patient, three treatment plans were generated: 3D-CRT, IMRT, and a hybrid technique. Plans were blindly scored by three experienced radiation oncologists. Several 2D and 3D anatomical parameters were extracted and statistically analyzed to evaluate their correlation with the selected treatment technique. IMRT was selected as the optimal technique in 73% of cases, while the hybrid approach was preferred in 27%; 3D-CRT was never selected. Significant differences between IMRT and hybrid plans were observed for multiple anatomical parameters, including lung and heart distances, target length, curvature volume, and LAD-related metrics. Univariate logistic regression showed that several parameters were associated with a higher likelihood of hybrid technique selection. Exploratory multivariate analysis confirmed these trends. The study identifies a set of anatomical parameters capable of supporting the a priori selection of the optimal radiotherapy planning strategy for left breast cancer. These findings highlight the importance of developing parameter-based models to personalize radiotherapy. Larger prospective and multicenter studies are warranted.