TARGIT-R (Retrospective): North American Experience with Intraoperative Radiation Using Low-Kilovoltage X-Rays for Breast Cancer.

MedStar author(s):
Citation: Annals of Surgical Oncology. 23(9):2809-15, 2016 SepPMID: 27160524Form of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter StudySubject headings: *Breast Neoplasms/th [Therapy] | *Carcinoma, Ductal, Breast/th [Therapy] | *Neoplasm Recurrence, Local | *Patient Selection | *Radiotherapy/ut [Utilization] | Adult | Aged | Aged, 80 and over | Breast Neoplasms/pa [Pathology] | Canada | Carcinoma, Ductal, Breast/sc [Secondary] | Disease-Free Survival | Female | Humans | Intraoperative Care | Lymphatic Metastasis | Mastectomy, Segmental/ae [Adverse Effects] | Middle Aged | Neoplasm Staging | Neoplasm, Residual | Radiotherapy Dosage | Radiotherapy/mt [Methods] | Registries | Retrospective Studies | Sentinel Lymph Node/pa [Pathology] | Tumor Burden | United StatesYear: 2016Local holdings: Available online from MWHC library: 1994 - presentISSN:
  • 1068-9265
Name of journal: Annals of surgical oncologyAbstract: BACKGROUND: 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.CONCLUSIONS: 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.METHODS: 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.RESULTS: 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.All authors: Abbott AM, Andolino DL, Bailey L, Bedi GC, Bethke KP, Boisvert ME, Bravo L, Cherian S, Collins BT, Deb N, Donnelly ED, Eaker JA, Escallon JM, Friedman NB, Fyles AW, Graves GM, Graves J, Greif JM, Grobmyer SR, Hermanto U, Hoefer RA, Joh JE, Kang SK, Kelemen P, Kelly T, Laronga C, Loftus L, Lottich SC, Lyons J, McCready DR, O'Rourke C, Pederson A, Police A, Riley L, Rohatgi N, Rosen B, Ross DL, Rudolph R, Ruffer J, Shaw CM, Small W Jr, Summer T, Tendulkar RD, Thompson WA 3rd, Tousimis EA, Uhl V, Valente SA, Willey SC, Wilson JPFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2018-02-21
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 27160524 Available 27160524

Available online from MWHC library: 1994 - present

BACKGROUND: 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.

CONCLUSIONS: 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.

METHODS: 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.

RESULTS: 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.

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