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The prescription dose was 50\u00a0Gy in 25 fractions. The conformity index (CI) and homogeneity index (HI) of the planning target volume (PTV) were evaluated. For organs at risk, the\n V<\/jats:italic>\n \n 5<\/jats:italic>\n <\/jats:sub>\n ,\n V<\/jats:italic>\n \n 10<\/jats:italic>\n <\/jats:sub>\n ,\n V<\/jats:italic>\n \n 20<\/jats:italic>\n <\/jats:sub>\n ,\n V<\/jats:italic>\n \n 30<\/jats:italic>\n <\/jats:sub>\n , and mean dose (\n Dmean<\/jats:italic>\n ) of the lungs and heart, as well as the\n Dmean<\/jats:italic>\n of the left anterior descending coronary artery (LAD), were analyzed. Beam-on time was recorded for each technique. Statistical analysis and data visualization were performed using R (version 4.3.2).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n All three techniques met clinical requirements for target coverage. VMAT achieved the highest CI (P\u2009<\u20090.05), with no significant difference in HI (P\u2009>\u20090.05) among the three techniques. HT-2.5 had a slightly lower Whole Lung-Dmean (10.59\u2009\u00b1\u20091.09\u00a0Gy) than VMAT (10.65\u2009\u00b1\u20090.69\u00a0Gy), but the difference was not statistically significant (P\u2009>\u20090.05). Whole Lung-V5% was significantly lower with HT-5 (52.61\u2009\u00b1\u20094.90%) (P\u2009<\u20090.05) and HT-2.5 (50.23\u2009\u00b1\u20094.43%) (P\u2009<\u20090.05) compared to VMAT (57.24\u2009\u00b1\u20095.37%), while VMAT had significantly lower\n V<\/jats:italic>\n \n 10<\/jats:italic>\n <\/jats:sub>\n (P\u2009<\u20090.05)and\n V<\/jats:italic>\n \n 20<\/jats:italic>\n <\/jats:sub>\n (P\u2009<\u20090.05). For the heart, HT-5 and HT-2.5 provided lower\n Dmean<\/jats:italic>\n (5.71\u2009\u00b1\u20091.07\u00a0Gy and 5.40\u2009\u00b1\u20090.94\u00a0Gy) (P\u2009<\u20090.05,P\u2009<\u20090.05) and\n V<\/jats:italic>\n \n 5<\/jats:italic>\n <\/jats:sub>\n (24.25\u2009\u00b1\u20098.25% and 21.88\u2009\u00b1\u20097.37%) (P\u2009<\u20090.05,P\u2009<\u20090.05) than VMAT (6.37\u2009\u00b1\u20090.95\u00a0Gy and 49.52\u2009\u00b1\u200913.33%). However, heart\n V<\/jats:italic>\n \n 30<\/jats:italic>\n <\/jats:sub>\n was significantly lower with VMAT compared to HT-5 (P\u2009<\u20090.05) and HT-2.5 (P\u2009<\u20090.05). LAD\n Dmean<\/jats:italic>\n was significantly lower with VMAT compared to HT-5 (P\u2009<\u20090.05) and HT-2.5(P\u2009<\u20090.05). Beam-on time was shortest with VMAT (4.5\u2009\u00b1\u20090.5\u00a0min), followed by HT-5 (8.1\u2009\u00b1\u20090.3\u00a0min) and HT-2.5 (14.8\u2009\u00b1\u20090.6\u00a0min).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n All three techniques offer acceptable target coverage for bilateral breast cancer. VMAT provides superior target conformity, LAD sparing, and the shortest treatment time. HT-5 and HT-2.5 demonstrate advantages in cardiac protection, with lower heart\n Dmean<\/jats:italic>\n and\n V<\/jats:italic>\n \n 5<\/jats:italic>\n <\/jats:sub>\n , while HT-2.5 offers the best reduction in low-dose lung exposure. Considering the combined factors of lung and heart sparing as well as overall treatment time, the Complete block type of 5\u00a0cm HT plan can also be recommended for synchronous bilateral breast cancer.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1186\/s12938-026-01574-x","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T18:16:04Z","timestamp":1779732964000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dosimetric comparison of three different radiotherapy regimens for bilateral breast cancer"],"prefix":"10.1186","volume":"25","author":[{"given":"Fanyang","family":"Kong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linyan","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingyuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meilian","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujing","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"issue":"3","key":"1574_CR1","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1038\/nrclinonc.2014.3","volume":"11","author":"SA Narod","year":"2014","unstructured":"Narod SA. 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