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Surgery, radiation, and systemic therapy are the three pillars of breast cancer treatment, with several strategies developed to combine them. The association of preoperative radiotherapy with immunotherapy may improve breast cancer tumor control by exploiting the tumor radio\u2010induced immune priming. However, this requires the use of hypofractionated radiotherapy (3\u00a0\u00d7\u00a08\u00a0Gy), increasing the risk of toxicity. Mini\u2010GRID therapy (mini\u2010GRT) is an innovative form of spatially fractionated radiation therapy (SFRT) characterized by narrow beam widths between 1 to 2\u00a0mm that promises a significant increase in normal tissue dose tolerances and could thereby represent a new alternative for preoperative breast cancer treatment. Mini\u2010GRT has been successfully implemented at the Hospital de Santiago de Compostela (Spain) with a flattening filter\u2010free LINAC (megavoltage x\u2010rays).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>In this dosimetry proof\u2010of\u2010concept study, we evaluate the feasibility of photon mini\u2010GRT for preoperative breast cancer treatment. We also assess the clinical potential of mini\u2010GRT and compare it with the current treatment standard of intensity\u2010modulated radiotherapy (IMRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seven unbiased breast cancer dosimetries of patients treated with stereotactic body radiotherapy (SBRT) (3\u00a0\u00d7\u00a08\u00a0Gy, IMRT) were selected for the study. Photon mini\u2010GRT was compared with SBRT using three main criteria: (i) the dose to organs at risk (OARs), (ii) the dose constraints dictated by normal tissue tolerance, and (iii) the lateral penumbra in OARs. Tumor coverage was evaluated in terms of normalized total dose at 8\u00a0Gy\u2010fractions. The optimized SBRT by IMRT was realized at the Institut Curie, Paris, France. The dose in mini\u2010GRT was calculated by means of Monte Carlo simulations based on the mini\u2010GRT implementation realized at the University Hospital in Santiago de Compostela.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to SBRT plans, mini\u2010GRT resulted in a reduction of the mean dose to the lungs, heart, chest wall, and lymph nodes in the studied cases by a factor ranging from 50% to 100%. Additionally, valley, mean, and peak doses to normal tissues meet the dose tolerance limits for the considered OARs, the most challenging of all being the skin. The mean dose to the skin was reduced (20%\u201360% less) for most of the studied cases. Mini\u2010GRT also yielded sharper lateral penumbras in the skin and lungs (size reduced by at least 50%). Similar tumor integral doses were obtained for the two treatment modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mini\u2010GRT with megavoltage x\u2010rays is an innovative treatment approach already implemented in a clinical context. In this proof\u2010of\u2010concept study, we evaluated mini\u2010GRT for partial breast cancer irradiation, demonstrating its potential for preoperative treatment thanks to the high skin and normal tissue\u2010sparing capabilities. These initial results represent a first step towards clinical use and encourage further prospective clinical studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.17634","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T10:44:31Z","timestamp":1738061071000},"page":"2493-2506","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Photon mini\u2010GRID therapy for preoperative breast cancer tumor treatment: A treatment plan study"],"prefix":"10.1002","volume":"52","author":[{"given":"Angela","family":"Corvino","sequence":"first","affiliation":[{"name":"Institut Curie Universit\u00e9 PSL CNRS UMR3347 Inserm U1021 Signalisation Radiobiologie et Cancer  Orsay France"},{"name":"Universit\u00e9 Paris\u2010Saclay CNRS UMR3347 Inserm U1021 Signalisation Radiobiologie et Cancer  Orsay 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