Delayed 2nd procedure intraoperative radiotherapy for breast cancer vs Whole breast radiotherapy

Just published – the first in the series of papers describing long-term outcomes of the TARGIT-A trial.

Conventional adjuvant radiotherapy for breast cancer given daily for several weeks is onerous and expensive. Some patients may be obliged to choose a mastectomy instead, and some may forgo radiotherapy altogether. In late 1990s, we proposed to test whether radiotherapy could be safely limited to the tumour bed.

There were two trials that tested this hypothesis:

In the randomised trial of immediate TARGIT-IORT vs EBRT, 2298 patients who had been diagnosed with breast cancer by needle biopsy were enrolled. They were randomly allocated to receive to receive TARGIT-IORT immediately during their lumpectomy under the same anaesthetic, or conventional post-operative radiotherapy over several weeks. Its previously published initial results showed that TARGIT-IORT was as effective as EBRT, and the manuscript describing its long-term outcomes is currently under review.

In this randomised trial of delayed TARGIT-IORT vs EBRT, 1153 patients who had already had a lumpectomy for breast cancer were enrolled. They were randomly allocated to receive EBRT or delayed TARGIT-IORT given as a second procedure by reopening the lumpectomy wound. This paper describes the long-term outcomes of this trial of delayed IORT.