CONCLUSIONS: The c-minimax model successfully overcomes the limitations of the PTV approach and the over-conservativeness of the minimax model, demonstrating significant advantages in managing uncertainties in complex cases, such as breast cancer. By providing superior robustness compared to PTV and reducing OAR doses relative to minimax, the model offers a flexible and clinically feasible strategy to enhance treatment quality. The marked reduction in high-dose regions (hotspots) in …