Radiotherapy for breast cancer, the TARGIT-A trial

Harness, Jay K.; Silverstein, Melvin J.; Wazer, David E.; Riker, Adam I.

doi:10.1016/s0140-6736(14)60829-1

Cited by 15 publications

(8 citation statements)

References 2 publications

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“…Harness et al and Yarnold et al argue that it is impossible for the 12-year-old Targit study, with a median follow-up of 29 months, to impact other cancer deaths, since the latency period for inducing non-breast cancers from breast treatment is known to be 15–20 years. 18 , 19 Furthermore, deaths from stroke and ischemic bowel disease cannot be attributed to breast irradiation. If you include only cardiac and breast cancer deaths, the difference between treatment arms is only two patients.…”

Section: Discussionmentioning

confidence: 99%

“…Mackenzie et al, Yarnold et al, and Harness et al argue that Vaidya et al’s assertion (fewer cardiac deaths from TARGIT) is inconsistent with the Darby study, the very study cited 1 in support of this claim. 1 , 7 18 – 22 Mackenzie et al suggest differences in baseline cardiac risk factors in the study groups are the most likely explanation for finding more cardiac deaths in the EBRT arm. 20 Vaidya et al concede that cardiovascular assessment was not recorded prior to study entry, but speculates that IORT of the tumor bed might have systemic beneficial effects that contribute to reduction in non-breast cancer mortality.…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative Radiation Therapy: A Critical Analysis of the ELIOT and TARGIT Trials. Part 2—TARGIT

Silverstein

Fastner

Maluta³

et al. 2014

Ann Surg Oncol

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BackgroundTwo randomized intraoperative radiation therapy trials for early-stage breast cancer were recently published. The ELIOT Trial used electrons (IOERT), and the TARGIT-A Trial Update used 50-kV X-rays (IORT). These studies were compared for similarities and differences. The results were analyzed and used to determine which patients might be suitable for single-dose treatment.MethodsThe primary sources of data were the ELIOT Trial and TARGIT-A Trial, as well as a comprehensive analysis of the peer-reviewed literature of accelerated partial breast irradiation (APBI) using 50-kV X-rays or electrons. Studies published or presented prior to March 2014 were analyzed for efficacy, patient restrictions, complications, and outcome.ResultsWith a median follow-up of 5.8 years, the 5-year recurrence rates for ELIOT versus EBRT patients were 4.4 and 0.4 %, respectively, p = 0.0001. A low-risk ELIOT group was identified with a 5-year recurrence rate of 1.5 %. With a median follow-up of 29 months, the 5-year recurrence rates for the TARGIT-A versus EBRT patients were 3.3 and 1.3 %, respectively, p = 0.042.ConclusionsWith 5.8 years of median follow-up, IOERT appears to have a subset of low risk women for whom IOERT is acceptable. With 29 months of median follow-up the results of IORT with 50-kV devices are promising, but longer follow-up data are required. At the current time, single-fraction IOERT or IORT patients should be treated under strict institutional protocols.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intraoperative Radiation Therapy: A Critical Analysis of the ELIOT and TARGIT Trials. Part 2—TARGIT

Silverstein

Fastner

Maluta³

et al. 2014

Ann Surg Oncol

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“…0·8 to 2·5) versus 3·5 (2·3 to 5·2) per cent; P = 0·009); this was attributable to fewer deaths from cardiovascular diseases and other cancers. However, overall survival and breast cancer mortality were not primary endpoints of the TARGIT trial and, as there is no biological explanation for the observed reduction in mortality from causes other than breast cancer, it would be premature to suggest that TARGIT treatment can result in improved non‐breast cancer survival. Radiation Therapy Oncology Group (RTOG) grade 3–4 side‐effects were reported to be lower in the IORT arm than in the EBRT arm (4 of 1720 versus 13 of 1731; P = 0·029).…”

Section: Resultsmentioning

confidence: 99%

Intraoperative radiotherapy in early breast cancer

Esposito

Anninga

Harris

et al. 2015

British Journal of Surgery

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“…To the Editor: We read with great interest the recent editorial by Hepel and Wazer (1) on the TARGIT-A trial (2), a study that has generated a tremendous amount of scientific debate (3)(4)(5)(6). Although we firmly believe that scientific debate is essential, the authors' main argument against Intrabeam therapy is based on a flawed premise.…”

Section: In Regard To Hepel and Wazermentioning

confidence: 99%