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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Breast Cancer
Volume 14 - 2024 |
doi: 10.3389/fonc.2024.1424630
This article is part of the Research Topic Emerging Insights Related to Real-World Data Analysis in Breast Cancer Research View all articles
Real world clinical outcomes from targeted intraoperative radiotherapy (TARGIT-IORT) during lumpectomy for breast cancer: data from a large cohort at a national cancer institute
Provisionally accepted- 1 Department of Radiation Oncology, Aviano Oncology Reference Center (IRCCS), Aviano, Italy
- 2 University College London, London, England, United Kingdom
- 3 Department of Surgical Oncology, Aviano Reference Center for Oncology (IRCCS), Aviano, Italy
- 4 Department of Medical Physics, Aviano Oncology Reference Center (IRCCS), Aviano, Italy
- 5 Aviano Oncology Reference Center (IRCCS), Aviano, Friuli-Venezia Giulia, Italy
- 6 Department of Medical Oncology, Aviano Oncology Reference Center (IRCCS), Aviano, Italy
Randomised evidence supports the use of partial breast irradiation (PBI) with targeted intraoperative radiotherapy (TARGIT-IORT) for early stage breast cancer, but the large adoption of this technique is still debated. The aim of this study is to determine if the outcome reported in TARGIT-A trial could be replicated in large cohort of early stage breast cancer treated with TARGIT-IORT.This prospective observational study analysed all patients treated with TARGIT-IORT between 2004 and 2021 in a single national cancer institute. TARGIT-IORT during lumpectomy was performed according to the risk-adapted TARGIT-A protocol using the Intrabeam ® device. We analysed the completeness of follow up, 5-year in-breast-tumour-recurrence (IBTR), long term local recurrence free survival, distant disease-free survival, overall survival and breast-cancer-related survival, using the Kaplan-Meyer method. A covariate analysis was performed to investigate risk factors for IBTR. We also analysed high grade toxicity events.The study included 814 patients and the a median follow up was 72 months. The majority of patients (60.3%) received TARGIT-IORT as PBI modality ("exclusive IORT" group); 39.7% received additional EBRT. There was no significant difference between the 5 years IBTR for the whole study population and the "exclusive IORT" cohort (1.6% (95%CI=1.1-2.1%) and 2.5% (95%CI=1.7%-3.3%) respectively). 5 years overall survival and tumour related survival were >95%. In 21% of patients with recurrence, breast was preserved. Radiotherapy toxicity (CTCAE Grade>2) was very rare (0.9%).This single institute found that breast cancer control and survival outcomes with TARGIT-IORT were consistent with TARGIT-A trial results. This "real world" experience confirmed that the randomised evidence showing the value of TARGIT-IORT as partial breast irradiation modality that can be replicated in the clinical practice.
Keywords: breast cancer, intraoperative radiotherapy, TARGIT-IORT, Real world data, Registry
Received: 28 Apr 2024; Accepted: 02 Sep 2024.
Copyright: © 2024 Vinante, Vaidya, Caroli, Mileto, Piccoli, Avanzo, Barresi, Marson, Montico, Baboci, Perin, Urbani, Puglisi, Mascarin and Massarut. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lorenzo Vinante, Department of Radiation Oncology, Aviano Oncology Reference Center (IRCCS), Aviano, Italy
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