Long-term results of TARGeted Intraoperative radioTherapy (Targit) boost during breast-conserving surgery

Jayant S. Vaidya, Michael Baum, Jeffrey S. Tobias, Frederik Wenz, Samuele Massarut, Mohammed Keshtgar, Basil Hilaris, Christobel Saunders, Norman R. Williams, Chris Brew-Graves, Tammy Corica, Mario Roncadin, Uta Kraus-Tiefenbacher, Marc Sütterlin, Max Bulsara, David Joseph

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Purpose: We have previously shown that delivering targeted radiotherapy to the tumour bed intraoperatively is feasible and desirable. In this study, we report on the feasibility, safety, and long-term efficacy of TARGeted Intraoperative radioTherapy (Targit), using the Intrabeam system. Methods and Materials: A total of 300 cancers in 299 unselected patients underwent breast-conserving surgery and Targit as a boost to the tumor bed. After lumpectomy, a single dose of 20 Gy was delivered intraoperatively. Postoperative external beam whole-breast radiotherapy excluded the usual boost. We also performed a novel individualized case control (ICC) analysis that computed the expected recurrences for the cohort by estimating the risk of recurrence for each patient using their characteristics and follow-up period. Results: The treatment was well tolerated. The median follow up was 60.5 months (range, 10-122 months). Eight patients have had ipsilateral recurrence: 5-year Kaplan Meier estimate for ipsilateral recurrence is 1.73% (SE 0.77), which compares well with that seen in the boosted patients in the European Organization for Research and Treatment of Cancer study (4.3%) and the UK STAndardisation of breast RadioTherapy study (2.8%). In a novel ICC analysis of 242 of the patients, we estimated that there should be 11.4 recurrences; in this group, only 6 recurrences were observed. Conclusions: Lumpectomy and Targit boost combined with external beam radiotherapy results in a low local recurrence rate in a standard risk patient population. Accurate localization and the immediacy of the treatment that has a favorable effect on tumour microenvironment may contribute to this effect. These long-term data establish the long-term safety and efficacy of the Targit technique and generate the hypothesis that Targit boost might be superior to an external beam boost in its efficacy and justifies a randomized trial.

Original languageEnglish
Pages (from-to)1091-1097
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume81
Issue number4
DOIs
Publication statusPublished - Nov 15 2011

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Segmental Mastectomy
acceleration (physics)
surgery
breast
radiation therapy
Radiotherapy
Recurrence
tumors
beds
Neoplasms
safety
Breast
cancer
Safety
Tumor Microenvironment
Kaplan-Meier Estimate
standardization
estimating
Therapeutics
dosage

Keywords

  • Boost
  • Breast cancer
  • Breast-conserving surgery
  • Recurrence rate
  • Targeted intraoperative radiotherapy (targit)

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Long-term results of TARGeted Intraoperative radioTherapy (Targit) boost during breast-conserving surgery. / Vaidya, Jayant S.; Baum, Michael; Tobias, Jeffrey S.; Wenz, Frederik; Massarut, Samuele; Keshtgar, Mohammed; Hilaris, Basil; Saunders, Christobel; Williams, Norman R.; Brew-Graves, Chris; Corica, Tammy; Roncadin, Mario; Kraus-Tiefenbacher, Uta; Sütterlin, Marc; Bulsara, Max; Joseph, David.

In: International Journal of Radiation Oncology Biology Physics, Vol. 81, No. 4, 15.11.2011, p. 1091-1097.

Research output: Contribution to journalArticle

Vaidya, JS, Baum, M, Tobias, JS, Wenz, F, Massarut, S, Keshtgar, M, Hilaris, B, Saunders, C, Williams, NR, Brew-Graves, C, Corica, T, Roncadin, M, Kraus-Tiefenbacher, U, Sütterlin, M, Bulsara, M & Joseph, D 2011, 'Long-term results of TARGeted Intraoperative radioTherapy (Targit) boost during breast-conserving surgery', International Journal of Radiation Oncology Biology Physics, vol. 81, no. 4, pp. 1091-1097. https://doi.org/10.1016/j.ijrobp.2010.07.1996
Vaidya, Jayant S. ; Baum, Michael ; Tobias, Jeffrey S. ; Wenz, Frederik ; Massarut, Samuele ; Keshtgar, Mohammed ; Hilaris, Basil ; Saunders, Christobel ; Williams, Norman R. ; Brew-Graves, Chris ; Corica, Tammy ; Roncadin, Mario ; Kraus-Tiefenbacher, Uta ; Sütterlin, Marc ; Bulsara, Max ; Joseph, David. / Long-term results of TARGeted Intraoperative radioTherapy (Targit) boost during breast-conserving surgery. In: International Journal of Radiation Oncology Biology Physics. 2011 ; Vol. 81, No. 4. pp. 1091-1097.
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AU - Keshtgar, Mohammed

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