Role of Anisotropic Analytical Algorithm and Acura’s XB Algorithm in the Treatment of Breast Cancer using Volumetric Modulated Arc Therapy Technique

Objective: To compare and analyses the dosimetric parameters between the anisotropic analytical algorithm and acuros XB (AXB) algorithm in volumetric modulated arc therapy plans for breast cancers Study Design: Retrospective studyPlace and Duration of Study: This study was conducted at the Warith International Cancer Institute, Al Thaqalyn Cancer Hospital Iraq, from 1st January 2025 to 30th June 2025. Methods: 30 women with left-sided breast cancer were enrolled. All the patients underwent for treatment by volumetric modulated arc therapy technique, where planning target volume dose calculation was using anisotropic analytical algorithm and acruos XB algorithms of the same optimisation parameters. The prescription doses to the target ranged between 4000 cGy and 5000 cGy. Results: There is a highly significant difference between anisotropic analytical algorithm and acruos XB calculations, where P-value was less than 0.05. For planning target volume 95% (breast), the calculation of the mean doses with anisotropic analytical algorithm and acruos XB were 93.58% and 94.83%, respectively (P=0.001). As well as, For planning target volume 90% (breast), the calculation of the mean doses with anisotropic analytical algorithm and acruos XB were 97.52% and 98.02%, respectively (P=0.01). At the same time, the mean dose of the PTV 10.7% (breast) was 9.33% and 13.36% for anisotropic analytical algorithm and acruos XB respectively (P=0.003). There are no significant differences between anisotropic analytical algorithm and acruos XB of the Boost cases and of the organ at risk. Conclusion: There is significant difference between anisotropic analytical algorithm and acruos XB calculation for breast cancer therapy. The dose delivered using acruos XB was higher than the anisotropic analytical algorithm while no significant difference was between anisotropic analytical algorithm and acruos XB analyses calculated using Boost. At the same time, no significant difference was between anisotropic analytical algorithm and acruos XB analyses calculated using volumetric modulated arc therapy with regard to lymph nodes and organs at risk (heart, lung, and spinal cord).