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- TARGIT-A
The TARGIT-A trial was an international multicenter prospective randomised phase 3 clinical trial designed to test whether a single dose of targeted intraoperative radiotherapy could replace the usual 3-6 week course of postoperative radiotherapy. The first results found no difference in cancer control and TARGIT also caused less radiotherapy related toxicity than whole breast radiotherapy[1]. The trial completed recruitment of 3451 patients in June 2012. The results, presented in the San Antonio Breast Cancer Conference in December 2012 2012 SABCS, Thursday 6 December, General Session 4 and later published[2], showed that that giving TARGIT at the time of lumpectomy, gives results similar to whole breast radiotherapy in terms of breast cancer control (particularly in ER PR positive cases), with fewer non-breast cancer deaths and a trend for lower overall mortality compared with conventional external beam whole breast radiotherapy. The results have been further clarified in the Red Journal[3].
The quality of life of patients who receive TARGIT is better than those who receive EBRT [4] Full text PDF. Analysis of distance travelled by breast cancer patients for taking their radiotherapy found that TARGIT IORT radiotherapy during lumpectomy for breast cancer could save millions of travel miles & tonnes of CO2, plus free up thousands of hours for women with early stage breast cancer, every year[5]. Full Text PDF. Video abstract.
- TARGIT in context with other forms of Partial Breast Irradiation (PBI)
A meta-analysis of randomised trials of partial breast irradiation (PBI) vs. whole breast irradiation (WBI) as part of breast conserving therapy demonstrated a reduction in non-breast-cancer and overall mortality. [6] Full text and Audio Slides
- TARGIT-B (Boost)
TARGIT as a tumour bed boost: In conventional EBRT, the boost is delivered at the end of a complete course of EBRT. Clinical evidence suggests that boost radiation improves treatment outcome for breast cancer.[7] With TARGIT the boost can be delivered intraoperatively without any delay and more precisely as compared to conventional EBRT. A multicenter clinical trial has demonstrated that the boost administered with IORT resulted in a lower than expected rate of local recurrence (1.73%) as compared to an EORTC study which used external boost radiation.[8][9][10]
As a tumour bed boost, TARGIT has been found to have a better than expected effectiveness[11][9][10] These results have prompted the inclusion of TARGIT boost as an option to EBRT boost in national clinical guidelines of many countries including Germany. Whether TARGIT is superior to an EBRT boost is being tested in a randomised trial IORT Boost TARGIT-B trial.
References
Vaidya, Jayant S; Joseph, David J; Tobias, Jeffrey S; Bulsara, Max; Wenz, Frederik; Saunders, Christobel; Alvarado, Michael; Flyger, Henrik L; Massarut, Samuele; Eiermann, Wolfgang; Keshtgar, Mohammed; Dewar, John; Kraus-Tiefenbacher, Uta; Sütterlin, Marc; Esserman, Laura; Holtveg, Helle MR; Roncadin, Mario; Pigorsch, Steffi; Metaxas, Marinos; Falzon, Mary; Matthews, April; Corica, Tammy; Williams, Norman R; Baum, Michael (July 2010). "Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial". The Lancet. 376 (9735): 91–102. doi:10.1016/s0140-6736(10)60837-9. PMID 20570343. Vaidya, Jayant S; Wenz, Frederik; Bulsara, Max; Tobias, Jeffrey S; Joseph, David J; Keshtgar, Mohammed; Flyger, Henrik L; Massarut, Samuele; Alvarado, Michael; Saunders, Christobel; Eiermann, Wolfgang; Metaxas, Marinos; Sperk, Elena; Sütterlin, Marc; Brown, Douglas; Esserman, Laura; Roncadin, Mario; Thompson, Alastair; Dewar, John A; Holtveg, Helle M R; Pigorsch, Steffi; Falzon, Mary; Harris, Eleanor; Matthews, April; Brew-Graves, Chris; Potyka, Ingrid; Corica, Tammy; Williams, Norman R; Baum, Michael (February 2014). "Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer: 5-year results for local control and overall survival from the TARGIT-A randomised trial". The Lancet. 383 (9917): 603–613. doi:10.1016/s0140-6736(13)61950-9. Vaidya, Jayant S.; Bulsara, Max; Wenz, Frederik; Joseph, David; Saunders, Christobel; Massarut, Samuele; Flyger, Henrik; Eiermann, Wolfgang; Alvarado, Michael; Esserman, Laura; Falzon, Mary; Brew-Graves, Chris; Potyka, Ingrid; Tobias, Jeffrey; Baum, Michael (April 2015). "Pride, Prejudice, or Science – attitudes towards the results of the TARGIT-A trial of targeted intraoperative radiotherapy for breast cancer". International Journal of Radiation Oncology*Biology*Physics. doi:10.1016/j.ijrobp.2015.03.022. Corica, Tammy; Nowak, Anna K.; Saunders, Christobel M.; Bulsara, Max; Taylor, Mandy; Vaidya, Jayant S.; Baum, Michael; Joseph, David J. (April 2016). "Cosmesis and breast-related quality of life outcomes following intra-operative radiotherapy for early breast cancer - a sub-study of the TARGIT-A trial". International Journal of Radiation Oncology*Biology*Physics. doi:10.1016/j.ijrobp.2016.04.024. Coombs, Nathan J; Coombs, Joel M; Vaidya, Uma J; Singer, Julian; Bulsara, Max; Tobias, Jeffrey S; Wenz, Frederik; Joseph, David J; Brown, Douglas A; Rainsbury, Richard; Davidson, Tim; Adamson, Douglas J A; Massarut, Samuele; Morgan, David; Potyka, Ingrid; Corica, Tammy; Falzon, Mary; Williams, Norman; Baum, Michael; Vaidya, Jayant S (9 May 2016). "Environmental and social benefits of the targeted intraoperative radiotherapy for breast cancer: data from UK TARGIT-A trial centres and two UK NHS hospitals offering TARGIT IORT". BMJ Open. 6 (5): e010703. doi:10.1136/bmjopen-2015-010703.{{cite journal}}: CS1 maint: article number as page number (link) CS1 maint: unflagged free DOI (link) Vaidya, Jayant S.; Bulsara, Max; Wenz, Frederik; Coombs, Nathan; Singer, Julian; Ebbs, Stephen; Massarut, Samuele; Saunders, Christobel; Douek, Michael; Williams, Norman; Joseph, David; Tobias, Jeffrey S.; Baum, Michael (May 2016). "Reduced mortality with partial breast irradiation for early breast cancer – a meta-analysis of randomised trials". International Journal of Radiation Oncology*Biology*Physics. doi:10.1016/j.ijrobp.2016.05.008. Vaidya JS, Baum M, Tobias J, Massarut S, Wenz F, Hilaris B, Corica T, Roncadin M, Kraus-Tiefenbacher U, Keshtgar M, Williams N, Brew-Graves C, Bulsara M, Saunders C, Joseph D (2009). "Targeted Intraoperative Radiotherapy (Targit) Boost after Breast Conserving Surgery Results in a Remarkably Low Recurrence Rate in a Standard Risk Population: 5 Year Results". Cancer Res. 69 (24 Suppl): Abstract nr 4104. doi:10.1158/0008-5472.SABCS-09-4104.{{cite journal}}: CS1 maint: multiple names: authors list (link) Vaidya, J. S.; Baum, M.; Tobias, J. S.; Wenz, F.; Massarut, S.; Keshtgar, M.; Hilaris, B.; Saunders, C.; Williams, N. R.; Brew-Graves, C.; Corica, T.; Roncadin, M.; Kraus-Tiefenbacher, U.; Sütterlin, M.; Bulsara, M.; Joseph, D. (15 Nov 2011). "Long-term Results of Targeted Intraoperative Radiotherapy (Targit) Boost during Breast-conserving Surgery". International Journal of Radiation OncologyBiologyPhysics. 81 (4): 1091–1097. doi:10.1016/j.ijrobp.2010.07.1996. PMID 20951505.
-- Jytdog (talk) 05:50, 19 May 2016 (UTC)
- per ...many of these references seem to be trials...maybe mention reference #6 meta-analysis(but not all the above references)-but need more opinions-Ozzie10aaaa (talk) 20:04, 15 April 2017 (UTC)
- We have a Cochrane review that comes to different conclusions. Would be good to par this down to just review articles. Doc James (talk · contribs · email) 23:32, 15 April 2017 (UTC)
- yes,much better!--Ozzie10aaaa (talk) 00:52, 16 April 2017 (UTC)
