Intrabeam | TARGIT IORT, ASTRO 2016
Reduced mortality with partial breast irradiation
“Our meta-analysis of 5-year data from published randomized trials of partial breast irradiation (PBI, alone or within a risk-adapted approach) vs. whole breast irradiation (WBI) for invasive breast cancer treated with lumpectomy, found no difference in breast cancer mortality (n=4489,difference 0.000%(95%CI -0.7 to +0.7),p=0.972). PBI was better than WBI for non-breast cancer mortality (n=4231,difference 1.1% (95%CI -2.1% to -0.2%),p=0.023), and total mortality (difference 1.3% (95%CI -2.5% – 0.0%),p=0.05), leading to a 25% relative risk reduction.”
In the figure below, PBI means Partial Breast Irradiation i.e., radiation only to the area near the tumour rather than the whole breast (Whole Breast Irradiation WBI).
The red diamond shows the overall effect from several trials with over 4000 patients. If the diamond sits on the vertical line, it means there is no effect – and if it is on the left it means that treatment is better for the patient.
So PBI (using TARGIT IORT as a single shot radiation at the time of lumpectomy for breast cancer, for example) reduces mortality, possibly by avoiding irradiation of vital organs, while maintaining cancer control.
Full paper can be accessed at:
www.sciencedirect.com/science/article/pii/S0360301616302000
http://www.redjournal.org/article/S0360-3016(16)30200-0/pdf
October 2014: American Brachytherapy Society
TARGIT-A and TARGIT-B trials: Invited talk at the American Brachytherapy Society meeting, Las Vegas, Oct 2013
September 2013: TARGIT at ASTRO, USA
Three papers were presented at ASTRO in Sepemeber 2013: two posters[1][2] and one oral presentation[3].
Professor Frederik Wenz reported that “Patients in the German centres in the TARGIT-A trial have excellent 5 year outcomes (local control >97%, overall survival !94%) in both arms of the trial”[2].
Professor Jayant Vaidya reported that “Omitting whole breast radiotherapy did not increase axillary recurrence rate in the TARGIT-A trial”[3]. and that “In addition to the avoidance of toxicity of whole breast radiotherapy, the reduction in non-breast cancer deaths may be the result of a beneficial effect of TARGIT with the hypothesis that the local effect of TARGIT on the tumor bed by inhibiting the cancer-stimulating cytokines, may spill over to reduce systemic inflammatory response to trauma and have significant long-term systemic beneficial effects, that might be protective against cardiac and cancer mortality[1].
Sepember 2013: TARGIT IORT at ECCO
Case selection for TARGIT using hormone receptor status:
On behalf of Professor Jayant S Vaidya, Dr Norman Williams presented a poster describing how hormone receptor status could be used for selecting cases for TARGIT [1]
March 2013: St Gallen Breast Cancer Conference
Two new posters:
December 2012: San Antonio Breast Cancer Symposium
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Late breaking plenary presentation at the 2012 San Antonio Breast Cancer Symposium: TARGIT-A trial: Updated results and first analysis of survival (click on Thursday, 6th December, then General Session 4, Second presentation)
September 2012: ASCO Breast Cancer Symposium, San Francisco
TARGIT-A and TARGIT-B Trials, plenary presentation
March 2012: Miami Breast Cancer Conference
This audience poll was conducted after a presentation by Jayant Vaidya in Miami via Skype from London.
Audience poll after TARGIT presentations
November 2011: BASO-ACS, London
TARGIT-A trial results: plenary lecture
Insert video from http://jayantvaidya.org/breast-cancer-surgeon/november-2011-baso-acs-london/