TY - JOUR
T1 - Targeted intraoperative radiotherapy (Targit) yields very low recurrence rates when given as a boost
AU - Vaidya, Jayant S.
AU - Baum, Michael
AU - Tobias, Jeffrey S.
AU - Massarut, Samuele
AU - Wenz, Frederik
AU - Murphy, Olive
AU - Hilaris, Basil
AU - Houghton, Joan
AU - Saunders, Christobel
AU - Corica, Tammy
AU - Roncadin, Mario
AU - Kraus-Tiefenbacher, Uta
AU - Melchaert, Frank
AU - Keshtgar, Mohammed
AU - Sainsbury, Richard
AU - Douek, Michael
AU - Harrison, Elly
AU - Thompson, Alastair
AU - Joseph, David
N1 - dc.publisher: Elsevier
PY - 2006/12
Y1 - 2006/12
N2 - Purpose: Patients undergoing breast-conserving surgery were offered boost radiotherapy with targeted intraoperative radiotherapy (TARGIT) using the Intrabeam system to test the feasibility, safety, and efficacy of the new approach. Methods and Materials: We treated 302 cancers in 301 unselected patients. This was not a low-risk group. One-third of patients (98/301) were younger than 51 years of age. More than half of the tumors (172, 57%) were between 1 cm and 2 cm, and one-fifth (62, 21%) were >2 cm; 29% (86) had a Grade 3 tumor and, in 29% (87), axillary lymph nodes contained metastasis. After primary surgery, 20 Gy was delivered intraoperatively to the surface of the tumor bed, followed by external-beam radiotherapy (EBRT), but excluding the usual boost. Results: The treatment was well tolerated. The follow-up ranged from 3 to 80 months (164 and 90 patients completed 2 and 3 years follow-up, respectively). Four patients (1.3%) had local recurrence. The Kaplan-Meier estimate of local recurrence is 2.6% (SE = 1.7) at 5 years. This compares favorably with the 4.3% recurrence rate in boosted patients from the EORTC boost study, in which only 8.1% patients were node-positive, as opposed to 29% in our series. Conclusion: Targeted intraoperative radiotherapy combined with EBRT results in a low local recurrence rate. This could be attributed to both accurate targeting and timeliness of the treatment. These data support the need for a randomized trial to test whether the TARGIT boost is superior to conventional external boost, especially in high-risk women.
AB - Purpose: Patients undergoing breast-conserving surgery were offered boost radiotherapy with targeted intraoperative radiotherapy (TARGIT) using the Intrabeam system to test the feasibility, safety, and efficacy of the new approach. Methods and Materials: We treated 302 cancers in 301 unselected patients. This was not a low-risk group. One-third of patients (98/301) were younger than 51 years of age. More than half of the tumors (172, 57%) were between 1 cm and 2 cm, and one-fifth (62, 21%) were >2 cm; 29% (86) had a Grade 3 tumor and, in 29% (87), axillary lymph nodes contained metastasis. After primary surgery, 20 Gy was delivered intraoperatively to the surface of the tumor bed, followed by external-beam radiotherapy (EBRT), but excluding the usual boost. Results: The treatment was well tolerated. The follow-up ranged from 3 to 80 months (164 and 90 patients completed 2 and 3 years follow-up, respectively). Four patients (1.3%) had local recurrence. The Kaplan-Meier estimate of local recurrence is 2.6% (SE = 1.7) at 5 years. This compares favorably with the 4.3% recurrence rate in boosted patients from the EORTC boost study, in which only 8.1% patients were node-positive, as opposed to 29% in our series. Conclusion: Targeted intraoperative radiotherapy combined with EBRT results in a low local recurrence rate. This could be attributed to both accurate targeting and timeliness of the treatment. These data support the need for a randomized trial to test whether the TARGIT boost is superior to conventional external boost, especially in high-risk women.
KW - Breast cancer
KW - Breast conserving therapy/surgery
KW - IORT
KW - Targeted intraoperative radiotherapy (Targit)
KW - Targit
KW - Recurrence rate
U2 - 10.1016/j.ijrobp.2006.07.1378
DO - 10.1016/j.ijrobp.2006.07.1378
M3 - Article
C2 - 17084562
SN - 0360-3016
VL - 66
SP - 1335
EP - 1338
JO - International Journal of Radiation Oncology - Biology - Physics (IJROBP)
JF - International Journal of Radiation Oncology - Biology - Physics (IJROBP)
IS - 5
ER -