The TARGIT-A Randomized Trial: TARGIT-IORT Versus Whole Breast Radiation Therapy: Long-Term Local Control and Survival

Vaidya, JS; Bulsara, Max; Wenz, Frederik; Sperk, Elena; Massarut, Samuele; Alvarado, Michael; Williams, Norman; Brew‐Graves, Chris; Bernstein, Marcelle; Holmes, Dennis R.; Vinante, Lorenzo; Pigorsch, Steffi; Lundgren, Steiner; Uhl, Valery; Joseph, David; Tobias, Jeffrey

doi:10.1016/j.ijrobp.2022.08.029

Cited by 11 publications

(3 citation statements)

References 29 publications

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“…Учитывая этот факт, следует рассмотреть возможность деэскалации лучевой терапии у определенной группы пациенток и заменить ее на ИОЛТ. В опубликованных долгосрочных результатах исследования TARGIT-A также не выявлено значимых различий в безрецидивной выживаемости, но отмечено, что рецидивы в группе дистанционной лучевой терапии чаще приводили к прогрессированию заболевания или смерти [20]. Риск прогрессирования или смерти составлял 43 % для пациентов с рецидивом в группе ДЛТ, что значительно выше, чем 9 % риск после местного рецидива в группе TARGIT-IORT.…”

Section: Discussionunclassified

“…Авторы объяснили это тем, что местные рецидивы, возникающие после ДЛТ, наблюдались при более агрессивных подтипах РМЖ, которые имеют неблагоприятный прогноз. Помимо этого, авторы указывали на возможность абскопального эффекта при применении однократной высокой дозы облучения, что могло как влиять на микроокружение опухоли, так и проявлять отдаленные иммунологические механизмы [8,20]. Еще один важный результат исследования TARGIT-A: смертность от рака молочной железы в обеих группах была одинаковой, что подтверждается и в нашем исследовании, однако в группе TARGIT-IORT сообщалось о гораздо меньшем количестве смертей от сопутствующих заболеваний.…”

Section: Discussionunclassified

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Comparison of the effectiveness of intraoperative radiotherapy with external beam radiotherapy in patients with early breast cancer

Manikhas,

Gor,

Topuzov

et al. 2024

Sib. onkol. ž.

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Background. Breast cancer is the most common cancer in women. The main treatment for breast cancer includes surgery, chemotherapy, radiation therapy, and hormone therapy. The role of radiation therapy in the management of breast cancer continues to evolve. Radiation therapy is currently being de-escalated to include the use of intraoperative radiotherapy (IORT) and adjuvant endocrine therapy. Purpose of the study: to compare the efficacy of IORT with that of external beam radiotherapy (EBRT) in the treatment of early breast cancer. Material and Methods. A retrospective study of 559 patients with early breast cancer was conducted in Clinical Oncology Center of Saint Petersburg. The main treatment group included 273 patients who underwent breast-conserving surgery with IORT and sentinel lymph node biopsy. The control group included 286 patients who underwent breast-conserving surgery with sentinel lymph node biopsy and EBRT. Results. For all patients, the median follow-up time was 59.1 months (interquartile range: 43.7 to 80.7), the minimum follow-up period was 0.6 months, and the maximum follow-up period was 110.4 months. Recurrence occurred in 18 (6.6 %) patients of the main group and in 8 (2.8 %) patients of the control group. A statistically significant association of biological subtype with survival outcomes was found (p=0.02). The hazard ratio for Luminal B of 1.88 (95 % CI 1.02, 3.46) corresponded to a 65 % chance of an earlier onset of a negative outcome. The hazard ratio for triple-negative breast cancer of 3.01 (95 % CI 1.53, 5.95) corresponded to a 75 % chance of an earlier negative outcome. In the main treatment group, 11 (4 %) patients developed disease progression, and 2 of them died of multiple organ failure. In the control group, disease progression was observed in 18 (6.3 %) patients, 6 of whom died. However, the analysis of overall survival using the Kaplan–Meier curve showed a statistically non-significant log-rank p-value (0.73). The 3-year survival rates were 100 % (100 – 100) in the treatment group and 98.2 % (96.7 – 99.8) in the control group. The 5-yaer survival rates were 99.3 % (97.9 – 100) in the treatment group and 97.8 % (96.2 – 99.6) in the control group. These results showed advantage of IORT over EBRT. Conclusions. Intraoperative radiotherapy is a safe and effective alternative to external beam radiotherapy for early breast cancer.

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Section: Discussionunclassified

Comparison of the effectiveness of intraoperative radiotherapy with external beam radiotherapy in patients with early breast cancer

Manikhas,

Gor,

Topuzov

et al. 2024

Sib. onkol. ž.

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“…In the recurrent situation, patients are also reporting a better QoL if treated with a second breast conserving operation compared to mastectomy (30)(31)(32). Intraoperative radiotherapy with a 50 kV X-ray-source (TARGIT-IORT) has become one standard of care in the local treatment of early breast cancer as an anticipated boost (33) but also as definitive radiation (34). This has led to the integration of TARGIT-IORT into national guidelines and recommendations (35) and it is also used in indications when radiation is problematic e.g., in patients with implants who do not want them to be removed in the course of BCS (36).…”

Section: Discussionmentioning

confidence: 99%

Breast Conserving Surgery in Combination With Targeted Intraoperative Radiotherapy Compared to Mastectomy for In-breast-tumor-recurrence

et al. 2023

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Hype or hope? A review of challenges in balancing tumor control and treatment toxicity in breast cancer from the perspective of the radiation oncologist

González-Viguera,

Martínez-Pérez,

Pérez-Montero

et al. 2023

Clin Transl Oncol

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The TARGIT-A Randomized Trial: TARGIT-IORT Versus Whole Breast Radiation Therapy: Long-Term Local Control and Survival

Cited by 11 publications

References 29 publications

Comparison of the effectiveness of intraoperative radiotherapy with external beam radiotherapy in patients with early breast cancer

Comparison of the effectiveness of intraoperative radiotherapy with external beam radiotherapy in patients with early breast cancer

Breast Conserving Surgery in Combination With Targeted Intraoperative Radiotherapy Compared to Mastectomy for In-breast-tumor-recurrence

Hype or hope? A review of challenges in balancing tumor control and treatment toxicity in breast cancer from the perspective of the radiation oncologist

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