Annals of Surgical Oncology

, Volume 23, Issue 9, pp 2809–2815

TARGIT-R (Retrospective): North American Experience with Intraoperative Radiation Using Low-Kilovoltage X-Rays for Breast Cancer

  • Stephanie A. Valente
  • Rahul D. Tendulkar
  • Sheen Cherian
  • Colin O’Rourke
  • Jon M. Greif
  • Lisa Bailey
  • Valery Uhl
  • Kevin P. Bethke
  • Eric D. Donnelly
  • Ray Rudolph
  • Aaron Pederson
  • Thomas Summer
  • S. Chace Lottich
  • Darrel L. Ross
  • Christine Laronga
  • Loretta Loftus
  • Andrea M. Abbott
  • Pond Kelemen
  • Ulrich Hermanto
  • Neil B. Friedman
  • Gauri C. Bedi
  • Jennifer E. Joh
  • William A. ThompsonIII
  • Richard A. Hoefer
  • Jason P. Wilson
  • Song K. Kang
  • Barry Rosen
  • James Ruffer
  • Luis Bravo
  • Alice Police
  • Jamie M. Escallon
  • Anthony W. Fyles
  • David R. McCready
  • Gregory M. Graves
  • Nitin Rohatgi
  • Joyce A. Eaker
  • Jannine Graves
  • Shawna C. Willey
  • Eleni A. Tousimis
  • Brian T. Collins
  • Christina M. Shaw
  • Lee Riley
  • Nimisha Deb
  • Tricia Kelly
  • David L. Andolino
  • Marc E. Boisvert
  • Joanne Lyons
  • William SmallJr.
  • Stephen R. Grobmyer
Breast Oncology

DOI: 10.1245/s10434-016-5240-1

Cite this article as:
Valente, S.A., Tendulkar, R.D., Cherian, S. et al. Ann Surg Oncol (2016) 23: 2809. doi:10.1245/s10434-016-5240-1

Abstract

Background

Single-dose intraoperative radiotherapy (IORT) is an emerging treatment for women with early stage breast cancer. The objective of this study was to define the frequency of IORT use, patient selection, and outcomes of patients treated in North America.

Methods

A multi-institutional retrospective registry was created, and 19 institutions using low-kilovoltage IORT for the treatment of breast cancer entered data on patients treated at their institution before July 31, 2013. Patient selection, IORT treatment details, complications, and recurrences were analyzed.

Results

From 2007 to July 31, 2013, a total of 935 women were identified and treated with lumpectomy and IORT. A total of 822 patients had at least 6 months’ follow-up documented and were included in the analysis. The number of IORT cases performed increased significantly over time (p < 0.001). The median patient age was 66.8 years. Most patients had disease that was <2 cm in size (90 %) and was estrogen positive (91 %); most patients had invasive ductal cancer (68 %). Of those who had a sentinel lymph node procedure performed, 89 % had negative sentinel lymph nodes. The types of IORT performed were primary IORT in 79 %, secondary IORT in 7 %, or planned boost in 14 %. Complications were low. At a median follow-up of 23.3 months, crude in-breast recurrence was 2.3 % for all patients treated.

Conclusions

IORT use for the treatment of breast cancer is significantly increasing in North America, and physicians are selecting low-risk patients for this treatment option. Low complication and local recurrence rates support IORT as a treatment option for selected women with early stage breast cancer.

Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Stephanie A. Valente
    • 1
  • Rahul D. Tendulkar
    • 1
  • Sheen Cherian
    • 1
  • Colin O’Rourke
    • 1
  • Jon M. Greif
    • 2
  • Lisa Bailey
    • 2
  • Valery Uhl
    • 2
  • Kevin P. Bethke
    • 3
  • Eric D. Donnelly
    • 3
  • Ray Rudolph
    • 4
  • Aaron Pederson
    • 4
  • Thomas Summer
    • 5
  • S. Chace Lottich
    • 6
  • Darrel L. Ross
    • 6
  • Christine Laronga
    • 7
  • Loretta Loftus
    • 7
  • Andrea M. Abbott
    • 7
  • Pond Kelemen
    • 8
  • Ulrich Hermanto
    • 8
  • Neil B. Friedman
    • 9
  • Gauri C. Bedi
    • 9
  • Jennifer E. Joh
    • 9
  • William A. ThompsonIII
    • 10
  • Richard A. Hoefer
    • 11
  • Jason P. Wilson
    • 11
  • Song K. Kang
    • 11
  • Barry Rosen
    • 12
  • James Ruffer
    • 12
  • Luis Bravo
    • 12
  • Alice Police
    • 13
  • Jamie M. Escallon
    • 14
  • Anthony W. Fyles
    • 14
  • David R. McCready
    • 14
  • Gregory M. Graves
    • 15
  • Nitin Rohatgi
    • 15
  • Joyce A. Eaker
    • 15
  • Jannine Graves
    • 15
  • Shawna C. Willey
    • 16
  • Eleni A. Tousimis
    • 16
  • Brian T. Collins
    • 16
  • Christina M. Shaw
    • 17
  • Lee Riley
    • 18
  • Nimisha Deb
    • 18
  • Tricia Kelly
    • 18
  • David L. Andolino
    • 18
  • Marc E. Boisvert
    • 19
  • Joanne Lyons
    • 1
  • William SmallJr.
    • 20
  • Stephen R. Grobmyer
    • 1
  1. 1.Cleveland ClinicClevelandUSA
  2. 2.Summit Medical CenterEmeryvilleUSA
  3. 3.Northwestern Memorial HospitalChicagoUSA
  4. 4.Memorial University Medical CenterSavannahUSA
  5. 5.Lafayette Surgical ClinicLafayetteUSA
  6. 6.Community Physician Network Breast Care, Community Health NetworkIndianapolisUSA
  7. 7.Moffitt Cancer CenterTampaUSA
  8. 8.Ashikari Breast CenterDobbs FerryUSA
  9. 9.Mercy Medical CenterBaltimoreUSA
  10. 10.Trinity Medical CenterBirminghamUSA
  11. 11.The Sentara Dorothy G. Hoefer Comprehensive Breast CenterNewport NewsUSA
  12. 12.Advocate Good Shepherd HospitalBarringtonUSA
  13. 13.University of California Irvine Medical CenterIrvineUSA
  14. 14.Princess Margaret Cancer CentreTorontoCanada
  15. 15.Sutter Cancer CenterSacramentoUSA
  16. 16.Medstar Georgetown University HospitalWashingtonUSA
  17. 17.University of FloridaGainesvilleUSA
  18. 18.St. Luke’s University Health NetworkBethlehemUSA
  19. 19.MedStar Washington Hospital CenterWashingtonUSA
  20. 20.Loyola UniversityChicagoUSA

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