Intraoperative radiotherapy for breast cancer: powerful evidence to change practice

Vaidya, JS; Bulsara, Max; Baum, Michael; Alvarado, Michael; Bernstein, Marcelle; Massarut, Samuele; Saunders, Christobel; Sperk, Elena; Wenz, Frederik; Tobias, Jeffrey

doi:10.1038/s41571-021-00471-7

Cited by 13 publications

(6 citation statements)

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“…It seems that we failed to convey our central argument in that Vaidya et al 1 complain that we overlooked the long-term positive findings and the patient perspective. We accept that targeted intraoperative radiotherapy during lumpectomy (TARGIT-IORT) is more convenient than conventional wholebreast external beam radiotherapy (WBRT).…”

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confidence: 77%

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Sasieni

Sawyer

2021

Nat Rev Clin Oncol

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confidence: 77%

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Sasieni

Sawyer

2021

Nat Rev Clin Oncol

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“…Over the last decade, there has been growing support for the use of partial breast irradiation (PBI) instead of whole-breast radiation therapy, and it is arguable that TARGIT-IORT is much better for patients than other methods of PBI ( 30 , 33 – 35 ). The TARGIT-A trial cohort comprised a medium-risk population, with a substantial number of patients at a higher risk of relapse: 1,898 (83%) were younger than 70 years, 366 (16%) had tumours >2 cm in size, 443 (20%) patients had grade 3 cancers, 488 (22%) patients had involved nodes, and 426 (19%) had ER- or PgR-negative tumours.…”

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confidence: 99%

Global adoption of single-shot targeted intraoperative radiotherapy (TARGIT-IORT) for breast cancer—better for patients, better for healthcare systems

Vaidya

Baum

et al. 2022

Front. Oncol.

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Micro abstractTargeted intraoperative radiotherapy (TARGIT-IORT) is delivered immediately after lumpectomy for breast cancer. We estimated its impact. At least 44,752 patients with breast cancer were treated with TARGIT-IORT in 260 centres in 35 countries, saving >20 million miles of travel and preventing ~2,000 non–breast cancer deaths. The TARGIT-IORT website (https://targit.org.uk/travel) provides maps and tools to find the nearest centre offering TARGIT-IORT and travel savings.BackgroundTargeted intraoperative radiotherapy (TARGIT-IORT) delivers radiotherapy targeted to the fresh tumour bed exposed immediately after lumpectomy for breast cancer. TARGIT-A trial found TARGIT-IORT to be as effective as whole-breast radiotherapy, with significantly fewer deaths from non–breast cancer causes. This paper documents its worldwide impact and provides interactive tools for clinicians and patients.MethodCentres using TARGIT-IORT provided the date of the first case and the total number of patients. We plotted these data on a customised Google Map. An interactive web-based tool provided directions to the closest centre. Using the data from the TARGIT-A trial, we estimated the total savings in travel miles, carbon footprint, and the number of non–breast cancer deaths that might be prevented.ResultsData from 242 (93%) of the 260 centres treating patients from 35 countries were available. From the first patient treated in 1998 to early 2020, at least 44,752 women with breast cancer have been treated with TARGIT-IORT. The TARGIT-IORT website (https://targit.org.uk/travel) displays the Google Map of centres with number of cases and an interactive tool for patients to find the nearest centre offering TARGIT-IORT and their travel savings. Scaling up to the already treated patients, >20 million miles of travel would have been saved and about 2,000 deaths prevented.ConclusionOne can ascertain the number of patients treated with a novel treatment. These data show how widely TARGIT-IORT has now been adopted and gives an indication of its beneficial worldwide impact on a large number of women with breast cancer.

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“…То есть анализ, проведенный еще в 2014 г., показал, что 5-летний риск локального рецидива составила 1,5 % для пациенток с низким риском прогрессирования. Иначе говоря, подбор наиболее благоприятной подгруппы пациенток на этапах лечения позволяет завершить местное лечение сразу же после лампэктомии с процедурой ИОЛТ [40,41].…”

Section: ускоренное частичное облучение молочной железыunclassified

“…больных РМЖ, присоединение послеоперационной лучевой терапии (ЛТ) к формирующемуся комбинированному подходу лечения раннего РМЖ привело к улучшению безрецидивной выживаемости на 17,4 % [11]. В настоящее время, согласно рекомендациям American Society for Radiation Oncology (ASTRO), после выполнения ОСО показана дистанционная лучевая терапия (ДЛТ) в режиме гипофракционирования суммарной очаговой дозы (СОД) [40][41][42]5 Гр за 15-16 фракций, а также может быть использован режим облучения в СОД 45-50,4 Гр за 25-28 фракций [5,12,13]. Дополнительно предлагается подведение источника облучения на область послеоперационного рубца ("boost") пациенткам с высоким риском рецидива в дозе 10-16 Гр, последовательно после ДЛТ.…”

Section: Introductionunclassified

Combined modality treatment of operable breast cancer using intraoperative radiotherapy

et al. 2023

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Objective of the study: To review worldwide literature data on the efficacy of combined modality treatment including intraoperative radiation therapy (IORT) in patients with operable breast cancer (BC). Material and Мethods. Of 110 publications (2000–2021) available from Scopus, Pubmed, Elibrary and other databases, using the key “breast cancer”, “local recurrence”, “intraoperative radiotherapy” and “radiation technique”, 45 were included in the literature review. Results. Radiotherapy is of paramount importance in the organpreserving treatment of breast cancer, as numerous randomised studies have shown that the use of postoperative radiotherapy dramatically reduces the number of locoregional recurrences. The use of IORT as an effective method of relapse prevention compared to standard postoperative adjuvant radiotherapy is an important trend in radiation oncology.Conclusion. The use of IORT in combination treatment modality for operable breast cancer should be differentiated and based on clinical and morphological prognostic factors. Different molecular subtypes of breast cancer are characterized by significant differences in pathogenesis and response to therapy. Further studies on the effectiveness of IORT are required to identify a group of patients with absolute indications for the use of IORT.

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Intraoperative radiotherapy for breast cancer: powerful evidence to change practice

Cited by 13 publications

References 10 publications

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Global adoption of single-shot targeted intraoperative radiotherapy (TARGIT-IORT) for breast cancer—better for patients, better for healthcare systems

Combined modality treatment of operable breast cancer using intraoperative radiotherapy

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