TARGIT-R (Retrospective): North American Experience with Intraoperative Radiation Using Low-Kilovoltage X-Rays for Breast Cancer
- 642 Downloads
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.
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.
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.
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.
KeywordsSentinel Lymph Node Early Stage Breast Cancer Positive Sentinel Lymph Node Accelerate Partial Breast Irradiation Sentinel Lymph Node Procedure
Supported by the Cleveland Clinic Breast Cancer Research Fund.
The authors declare no conflict of interest.
- 1.Early Breast Cancer Trialists’ Collaborative Group, Darby S, McGale P, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378(9804):1707–16.CrossRefGoogle Scholar
- 3.Kunkler IH, Williams LJ, Jack WJ, Cameron DA, Dixon JM, investigators PI. Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial. Lancet Oncol. 2015;16:266–73.Google Scholar
- 11.Blom Goldman U, Svane G, Anderson M, Wennberg B, Lind P. Long-term functional and radiological pulmonary changes after radiation therapy for breast cancer. Acta Oncol. 2014;53:1373–9.Google Scholar
- 30.Abbott A, Laronga C, Valente SA, et al. A multi-institutional analysis of intraoperative radiotherapy for early breast cancer: does age matter? (abstract). Ann Surg Oncol. 2015;22:22.Google Scholar