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

Purpose: Brachial plexopathy in breast cancer patients undergoing radiation therapy is an important side effect. The primary objective of this study was to compare the dose of two different treatment methods, the wedge 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. Materials and Methods: The study involved 100 breast cancer patients who underwent 25 radiation therapy fractions. The total radiation dose delivered throughout the therapy was 50 Gy, with 2 Gy per fraction. Results: The mean of maximum dose delivered to the brachial plexus was 5302.18-±2.8 cGy in the wedge group, and 5242.5 ±1.37cGy 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 ±5.33cGy, while the field-in-field method had a mean dose of 4351.9±4.65 cGy and their difference was not statistically significant (P > 0.05). Conclusion: 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.