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New clinical and biological insights from the international TARGIT-A randomised trial of targeted intraoperative radiotherapy during lumpectomy for breast cancer

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Single-dose intraoperative radiotherapy during lumpectomy for breast cancer: an innovative patient-centred treatment

    Research output: Contribution to journalComment/debateResearchpeer-review

  2. CYP3A7*1C allele: linking premenopausal oestrone and progesterone levels with risk of hormone receptor-positive breast cancers

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Breast cancer survival in Nordic BRCA2 mutation carriers-unconventional association with oestrogen receptor status

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Jayant S. Vaidya
  • Max Bulsara
  • Michael Baum
  • Frederik Wenz
  • Samuele Massarut
  • Steffi Pigorsch
  • Michael Alvarado
  • Michael Douek
  • Christobel Saunders
  • Henrik Flyger
  • Wolfgang Eiermann
  • Chris Brew-Graves
  • Norman R. Williams
  • Ingrid Potyka
  • Nicholas Roberts
  • Marcelle Bernstein
  • Douglas Brown
  • Elena Sperk
  • Siobhan Laws
  • Marc Sütterlin
  • Tammy Corica
  • Steinar Lundgren
  • Dennis Holmes
  • Lorenzo Vinante
  • Fernando Bozza
  • Montserrat Pazos
  • Magali Le Blanc-Onfroy
  • Günther Gruber
  • Wojciech Polkowski
  • Konstantin J. Dedes
  • Marcus Niewald
  • Jens Blohmer
  • David McReady
  • Richard Hoefer
  • Pond Kelemen
  • Gloria Petralia
  • Mary Falzon
  • David Joseph
  • Jeffrey S. Tobias
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Background: The TARGIT-A trial reported risk-adapted targeted intraoperative radiotherapy (TARGIT-IORT) during lumpectomy for breast cancer to be as effective as whole-breast external beam radiotherapy (EBRT). Here, we present further detailed analyses. Methods: In total, 2298 women (≥45 years, invasive ductal carcinoma ≤3.5 cm, cN0–N1) were randomised. We investigated the impact of tumour size, grade, ER, PgR, HER2 and lymph node status on local recurrence-free survival, and of local recurrence on distant relapse and mortality. We analysed the predictive factors for recommending supplemental EBRT after TARGIT-IORT as part of the risk-adapted approach, using regression modelling. Non-breast cancer mortality was compared between TARGIT-IORT plus EBRT vs. EBRT. Results: Local recurrence-free survival was no different between TARGIT-IORT and EBRT, in every tumour subgroup. Unlike in the EBRT arm, local recurrence in the TARGIT-IORT arm was not a predictor of a higher risk of distant relapse or death. Our new predictive tool for recommending supplemental EBRT after TARGIT-IORT is at https://targit.org.uk/addrt. Non-breast cancer mortality was significantly lower in the TARGIT-IORT arm, even when patients received supplemental EBRT, HR 0.38 (95% CI 0.17–0.88) P = 0.0091. Conclusion: TARGIT-IORT is as effective as EBRT in all subgroups. Local recurrence after TARGIT-IORT, unlike after EBRT, has a good prognosis. TARGIT-IORT might have a beneficial abscopal effect. Trial registration: ISRCTN34086741 (21/7/2004), NCT00983684 (24/9/2009).

Original languageEnglish
JournalBritish Journal of Cancer
Volume125
Issue number3
Pages (from-to)380-389
Number of pages10
ISSN0007-0920
DOIs
Publication statusPublished - 3 Aug 2021

ID: 66209005