Comparative Analysis of AAA and AXB Algorithms in Eclipse Treatment Planning System for Lung SBRT Radiotherapy

Ibrahim, Fayza Hussein; Awad, Sahar M.; Elshahat, Khaled Mohamed; Awad, Ola

doi:10.21608/ijtar.2025.348904.1104

Comparative Analysis of AAA and AXB Algorithms in Eclipse Treatment Planning System for Lung SBRT Radiotherapy

Document Type : Original Article

Authors

¹ Biophysics, the faculty of science, Al Azhar university, Egypt

² Physics department , faculty of science , Al Azhar university

³ Clinical oncology dept. Physics unit Faculty of Medicine Al Azhar university

⁴ Department of Physics, Faculty of Science, Al-Azhar University (Girls Branch), Cairo , Egypt

10.21608/ijtar.2025.348904.1104

Abstract

Stereotactic Body Radiotherapy (SBRT) is a precise treatment for lung tumors, delivering high fractional doses in a short time to improve local control and survival while reducing adverse effects. Accurate dose calculation algorithms are essential for optimizing treatment outcomes. This study compares two commonly used algorithms: Anisotropic Analytical Algorithm (AAA) and Acuros XB (AXB). AAA is known for its speed but struggles with tissue heterogeneity, while AXB is designed for better calculations in heterogeneous media, potentially enhancing lung SBRT planning. The aim of this study is to conduct a comparative analysis of the dosimetric performance of AAA and AXB within the Eclipse TPS for lung SBRT, focusing on dosimetric accuracy, plan quality, and clinical implications. The study included 20 patients with lung tumors, using CT scans imported into the Eclipse TPS. SBRT plans were generated with both algorithms using non-coplanar beams at 6 MV FFF energy. Plans were optimized to ensure target volume coverage while minimizing exposure to organs at risk (OARs). Dosimetric parameters like the Conformity Index (CI), Homogeneity Index (HI), and dose-volume histograms (DVHs) were compared. Results showed both algorithms provided acceptable dose distributions, with AAA achieving slightly higher target coverage and better homogeneity. AXB, however, demonstrated improved sparing of OARs. Both algorithms maintained clinically acceptable doses, with AXB offering better dosimetric accuracy and sparing of OARs. Future studies should focus on clinical validations of these findings.

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