BACKGROUND: Intraoperative radiation therapy (IORT) has been investigated for patients with low-risk, early-stage breast cancer. The The North American experience was evaluated by TARGIT-R (retrospective) to provide outcomes for patients treated in "real-world" clinical practice with breast IORT. This analysis presents a 5-year follow-up assessment. METHODS: TARGIT-R is a multi-institutional retrospective registry of patients who underwent lumpectomy and IORT between the years 2007 and 2013. The primary outcome of the evaluation was ipsilateral breast tumor recurrence (IBTR). RESULTS: The evaluation included 667 patients with a median follow-up period of 5.1 years. Primary IORT (IORT at the time of lumpectomy) was performed for 72%, delayed IORT (after lumpectomy) for 3%, intended boost for 8%, and unintended boost (primary IORT followed by whole-breast radiation) for 17% of the patients. At 5 years, IBTR was 6.6% for all the patients, with 8% for the primary IORT cohort and 1.7% for the unintended-boost cohort. No recurrences were identified in the delayed IORT or intended-boost cohorts. Noncompliance with endocrine therapy (ET) was associated with higher IBTR risk (hazard ratio [HR], 3.67). Patients treated with primary IORT who were complaint with ET had a 5-year IBTR rate of 3.9%. CONCLUSION: The local recurrence rates in this series differ slightly from recent results of randomized IORT trials and are notably higher than in previous published studies using whole-breast radiotherapy for similar patients with early-stage breast cancer. Understanding differences in this retrospective series and the prospective trials will be critical to optimizing patient selection and outcomes going forward.
BACKGROUND: Intraoperative radiation therapy (IORT) has been investigated for patients with low-risk, early-stage breast cancer. The The North American experience was evaluated by TARGIT-R (retrospective) to provide outcomes for patients treated in "real-world" clinical practice with breast IORT. This analysis presents a 5-year follow-up assessment. METHODS: TARGIT-R is a multi-institutional retrospective registry of patients who underwent lumpectomy and IORT between the years 2007 and 2013. The primary outcome of the evaluation was ipsilateral breast tumor recurrence (IBTR). RESULTS: The evaluation included 667 patients with a median follow-up period of 5.1 years. Primary IORT (IORT at the time of lumpectomy) was performed for 72%, delayed IORT (after lumpectomy) for 3%, intended boost for 8%, and unintended boost (primary IORT followed by whole-breast radiation) for 17% of the patients. At 5 years, IBTR was 6.6% for all the patients, with 8% for the primary IORT cohort and 1.7% for the unintended-boost cohort. No recurrences were identified in the delayed IORT or intended-boost cohorts. Noncompliance with endocrine therapy (ET) was associated with higher IBTR risk (hazard ratio [HR], 3.67). Patients treated with primary IORT who were complaint with ET had a 5-year IBTR rate of 3.9%. CONCLUSION: The local recurrence rates in this series differ slightly from recent results of randomized IORT trials and are notably higher than in previous published studies using whole-breast radiotherapy for similar patients with early-stage breast cancer. Understanding differences in this retrospective series and the prospective trials will be critical to optimizing patient selection and outcomes going forward.
Authors: Gustavo R Sarria; Maria L Ramos; Amalia Palacios; Ruben Del Castillo; Felipe Castro; Angel Calvo; Jose M Cotrina; Adela Heredia; Jose A Galarreta; Paola Fuentes-Rivera; Alicia Avalos; David A Martinez; Kevin Colqui; Gonzalo Ziegler; Leonard Christopher Schmeel; Luis V Pinillos; Frederik Wenz; Frank A Giordano; Gustavo J Sarria; Elena Sperk Journal: Front Oncol Date: 2022-03-17 Impact factor: 6.244
Authors: Fantine Giap; Lillie O'steen; I-Chia Liu; Lisa E Spiguel; Christiana M Shaw; Christopher G Morris; Raymond B Mailhot Vega; Judith L Lightsey; Julie A Bradley; Nancy P Mendenhall; Paul G Okunieff; Natalie A Lockney Journal: Rep Pract Oncol Radiother Date: 2022-09-19
Authors: Raluca Stoian; Thalia Erbes; Constantinos Zamboglou; Jutta Scholber; Mark Gainey; Ilias Sachpazidis; Erik Haehl; Simon K B Spohn; Vivek Verma; David Krug; Alexander Rühle; Ingolf Juhasz-Böss; Anca-Ligia Grosu; Nils H Nicolay; Tanja Sprave Journal: Strahlenther Onkol Date: 2021-04-30 Impact factor: 3.621
Authors: Melvin J Silverstein; Melinda S Epstein; Peter Chen; Kevin Lin; Sadia Khan; Lincoln Snyder; Colleen Coleman; Lisa Guerra; Farideh Dehkordi-Vakil; Brian Kim Journal: Ann Surg Oncol Date: 2022-01-22 Impact factor: 4.339