Environmental and social benefits of the targeted intraoperative radiotherapy for breast cancer: Data from UK TARGIT-A trial centres and two UK NHS hospitals offering TARGIT IORT

TY - JOUR

T1 - Environmental and social benefits of the targeted intraoperative radiotherapy for breast cancer

T2 - Data from UK TARGIT-A trial centres and two UK NHS hospitals offering TARGIT IORT

AU - Coombs, Nathan J.

AU - Coombs, Joel M.

AU - Vaidya, Uma J.

AU - Singer, Julian

AU - Bulsara, Max

AU - Tobias, Jeffrey S.

AU - Wenz, Frederik

AU - Joseph, David J.

AU - Brown, Douglas A.

AU - Rainsbury, Richard

AU - Davidson, Tim

AU - Adamson, Douglas J A

AU - Massarut, Samuele

AU - Morgan, David

AU - Potyka, Ingrid

AU - Corica, Tammy

AU - Falzon, Mary

AU - Williams, Norman

AU - Baum, Michael

AU - Vaidya, Jayant S.

PY - 2016/5/9

Y1 - 2016/5/9

N2 - Objective: To quantify the journeys and CO2 emissions if women with breast cancer are treated with risk-adapted single-dose targeted intraoperative radiotherapy (TARGIT) rather than several weeks' course of external beam whole breast radiotherapy (EBRT) treatment. Setting: (1) TARGIT-A randomised clinical trial (ISRCTN34086741) which compared TARGIT with traditional EBRT and found similar breast cancer control, particularly when TARGIT was given simultaneously with lumpectomy, (2) 2 additional UK centres offering TARGIT. Participants: 485 UK patients (249 TARGIT, 236 EBRT) in the prepathology stratum of TARGIT-A trial (where randomisation occurred before lumpectomy and TARGIT was delivered simultaneously with lumpectomy) for whom geographical data were available and 22 patients treated with TARGIT after completion of the TARGIT-A trial in 2 additional UK breast centres. Outcome measures: The shortest total journey distance, time and CO2 emissions from home to hospital to receive all the fractions of radiotherapy. Methods: Distances, time and CO2 emissions were calculated using Google Maps and assuming a fuel efficiency of 40 mpg. The groups were compared using the Student t test with unequal variance and the nonparametric Wilcoxon rank-sum (Mann-Whitney) test. Results: TARGIT patients travelled significantly fewer miles: TARGIT 21 681, mean 87.1 (SE 19.1) versus EBRT 92 591, mean 392.3 (SE 30.2); had lower CO2 emissions 24.7 kg (SE 5.4) vs 111 kg (SE 8.6) and spent less time travelling: 3 h (SE 0.53) vs 14 h (SE 0.76), all p2 per patient). Conclusions: The use of TARGIT intraoperative radiotherapy for eligible patients with breast cancer significantly reduces their journeys for treatment and has environmental benefits. If widely available, 5 million miles (8 000 000 km) of travel, 170 000 woman-hours and 1200 tonnes of CO2 (a forest of 100 hectares) will be saved annually in the UK. Trial registration number: ISRCTN34086741; Post-results.

AB - Objective: To quantify the journeys and CO2 emissions if women with breast cancer are treated with risk-adapted single-dose targeted intraoperative radiotherapy (TARGIT) rather than several weeks' course of external beam whole breast radiotherapy (EBRT) treatment. Setting: (1) TARGIT-A randomised clinical trial (ISRCTN34086741) which compared TARGIT with traditional EBRT and found similar breast cancer control, particularly when TARGIT was given simultaneously with lumpectomy, (2) 2 additional UK centres offering TARGIT. Participants: 485 UK patients (249 TARGIT, 236 EBRT) in the prepathology stratum of TARGIT-A trial (where randomisation occurred before lumpectomy and TARGIT was delivered simultaneously with lumpectomy) for whom geographical data were available and 22 patients treated with TARGIT after completion of the TARGIT-A trial in 2 additional UK breast centres. Outcome measures: The shortest total journey distance, time and CO2 emissions from home to hospital to receive all the fractions of radiotherapy. Methods: Distances, time and CO2 emissions were calculated using Google Maps and assuming a fuel efficiency of 40 mpg. The groups were compared using the Student t test with unequal variance and the nonparametric Wilcoxon rank-sum (Mann-Whitney) test. Results: TARGIT patients travelled significantly fewer miles: TARGIT 21 681, mean 87.1 (SE 19.1) versus EBRT 92 591, mean 392.3 (SE 30.2); had lower CO2 emissions 24.7 kg (SE 5.4) vs 111 kg (SE 8.6) and spent less time travelling: 3 h (SE 0.53) vs 14 h (SE 0.76), all p2 per patient). Conclusions: The use of TARGIT intraoperative radiotherapy for eligible patients with breast cancer significantly reduces their journeys for treatment and has environmental benefits. If widely available, 5 million miles (8 000 000 km) of travel, 170 000 woman-hours and 1200 tonnes of CO2 (a forest of 100 hectares) will be saved annually in the UK. Trial registration number: ISRCTN34086741; Post-results.

U2 - 10.1136/bmjopen-2015-010703

DO - 10.1136/bmjopen-2015-010703

M3 - Article

C2 - 27160842

AN - SCOPUS:84971282319

SN - 2044-6055

VL - 6

JO - BMJ Open

JF - BMJ Open

IS - 5

M1 - e010703

ER -