TARGIT
Targit trial – Targeted Intraoperative Radiotherapy for Breast Cancer
The TARGIT trial
[please scroll down to see the trial design and past literature]
15 March 2012 Audience poll at the Miami Breast Cancer Conference, USA. CLICK the see the video
29 April 2011- TARGIT trial plenary lecture gets strong support at American Society of Breast Surgeons meeting, Washington DC, USA
19 March 2011
At the 12th International St.Gallen Breast Cancer Conference
16-19 March 2011 / St.Gallen, Switzerland, the delegates (n~4200) at the Consensus session on the last day of the conference voted in favour of using intraoperative radiotherapy.
Voting results for the following questions were as follows:
In association with breast conserving surgery,
partial breast irradiation (intraoperative) is acceptable
- As definitive radiation, without any external beam therapy?
Yes= 48.9%, No=35.6%, Don’t know= 15.6%

In association with breast conserving surgery,
partial breast irradiation (intraoperative) is acceptable
- Instead of external beam boost to tumour bed?
Yes= 60.9%, No=17.4%, Don’t know= 21.7%

Should partial breast radiotherapy be applied
in selected patients (including intraoperative)
- Elderly (> age 70) ?
Yes = 86.7%, No=6.7%, Don’t know=6.7%
Should partial breast radiotherapy be applied
in selected patients (including intraoperative)
- Lymphoma survivors after mantle field RT?
Yes= 37.2%, No=25.6%, Don’t know=37.2%

2010 NEWS FLASH: TARGIT-A trial results at ASCO and in the Lancet
The results of the TARGIT-A trial published in The Lancet Online first
Oral presentation at the TARGIT Symposium, ASCO, Chicago, USA
7 June 2010
Poster Discussion, ASCO, Chicago, USA
Click here to read a brief description of the TARGIT-A trial and its results
In the randomised TARGIT trial, two policies of local radiation treatment are being compared:
Breast cancer patient (>=45 years) suitable for breast conserving surgery
RANDOMISE


TARGIT group (A)
Individualised-Risk-Adjusted Radiotherapy
A single dose of TARGIT with Intrabeam (in ~85%)
+
if high risk*
add EBRT (45-50Gy, no boost)
*prespeficied criteria e.g., unsuspected lobular carcinoma, lymphovascular invasion, etc.
EBRT group (B)
One-size-fits-all Radiotherapy
Standard 4-6 week course of external beam radiotherapy (EBRT)
40-56Gy in 15-25 fractions
+/-
Tumour bed boost
10-16 G y in 5-8 fractions
Eligible patients can be recruited at two stages of their treatment in the pragmatic Targit trial:
Before the primary surgery
If a patient is to have her primary breast cancer operation at a hospital where intraoperative radiotherapy ( radiation treatment ) can be given, then randomisation in the Targit trial can be done before surgery and intraoperative radiation treatment can be given at the same time as the lumpectomy for breast cancer, if they draw the arm (B). If at the postoperative pathology review, it is felt that they have a particularly high risk of local recurrence especially in other quadrants (e.g., EIC, extensive LVI or nodal metastases, etc) then external beam radiotherapy can be added and the patient will remain in the trial.
After the primary surgery
If primary surgery is performed elsewhere, randomisation in the Targit trial can be performed after the primary surgery (lumpectomy or wide local excision) and they can have a single session intraoperative radiotherapy as a day-case operation . If a patient draws arm a) external beam radiotherapy can be administered at their usual hospital (we will have recorded the exact schedule).
The TARGIT technique uses the Intrabeam device for delivering precise and timely dose of intraoperative radiotherapy accurately to the tumour bed. This device was developed by an collaborative effort between University College London and the industry. It has had extensive experience since its first use in July 1998.
Visit: The TARGIT trial Blog
Targeted intraoperative radiotherapy Literature
[NOTE: these papers can be downloaded strictly for personal use only. This site is maintained by Dr Jayant S Vaidya ]
Pathological and biological rationale of
partial breast irradiation (PBI) and the basis of the Targit Trial
1995 Hongkong International Cancer Congress
1996 British Journal of Cancer
Could MRI be useful to select patients for breast conserving surgery?
The Core trial Protocol of the Targit Trial
The UK Pilot Study of intraoperative radiation therapy:
the first full paper about Targit
The surgical technique of targeted intraoperative radiotherapy
(TARGIT) for early breast cancer treatment
as used in the Targit trial
2002 European Journal of Surgical Oncology
A possible one-stop out patient treatment for small breast cancers
PhD Thesis of Jayant S Vaidya
2002 University College London PhD Thesis
Some publicity
2003 San Antonio Breast Cancer Symposium
30-minute invited presentation about the Targit trial
Poster discussion about cosmetic results of
the (Targit) intraoperative radiation therapy boost cases
Acute and Late Toxicity data about the Targit approach.
2004 ANZ Journal of Surgical Oncology
2006 Int J Rad Oncol Biol Phys
Reviews, Editorial, Viewpoint
2004 British Journal of Radiology
2005 Seminas in Radiation Oncology
2007 Nature Clinical Practice Oncology
2008 Annals of New York Academy of Sciences
Book Chapters
2003 Recent Advances in Surgery
2006 Accelerated Partial Breast Irradiation (1st Edition)
2009 Accelerated Partial Breast Irradiation (2nd Edition)
Radiobiology of Targeted intraoperation radiation therapy (TARGIT)
Mathematical Modelling of breast cancer growth, recurrence
and intra-operative radiotherapy (IORT)
2005 Cancer Research UK Award Poster
2006 Journal of Theoretical Biology
2007 Journal of Theoretical Biology
Targit under Local Anaesthetic
2006 World Journal of Surgical Oncology
Targit boost :- results in a very low recurrence
2006 International Journal or Radiation Oncology Biology Physics
2008 American Society of Clinical Oncology (ASCO)
2010 International Journal or Radiation Oncology Biology Physics
5-yr actuarial = 1.73% - half the expected recurrence rate
Novel effects of TARGIT on tumour micro-environment
2009 International Journal of Radiation Oncology Biology Physics
Patient Information about Targit as a Single Procedure
Patient Information about Targit as a Subsequent Procedure
TARGIT is an elegant approach of partial breast irradiation (PBI) for breast cancer. Please scroll down to access literature about TARGIT