Intraoperative Radiotherapy for Breast Cancer Treatment in a Rural Community

Lorenzen, Allison W.; Kiriazov, Boris; Andrade, James P. De; Lizarraga, Ingrid M.; Scott‐Conner, Carol E. H.; Sugg, Sonia L.; Erdahl, Lillian M.; Sun, Wenqing; Weigel, Ronald J.

doi:10.1245/s10434-018-6574-7

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…Furthermore, IORT is a cost-effective option ( 57 ). Therefore, for patients in rural communities, IORT might be an alternative choice, because these women tend to be older and live farther from therapeutic centers ( 58 ).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Radiotherapy Is Not a Better Alternative to Whole Breast Radiotherapy as a Therapeutic Option for Early-Stage Breast Cancer

et al. 2021

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ObjectiveIntraoperative radiotherapy (IORT) in early-stage breast cancer has been studied over the years. However, it has not been demonstrated whether IORT is more suitable as a therapeutic option for early-stage breast cancer than whole breast radiotherapy (WBRT). Therefore, we performed a meta-analysis to compare the efficacy and safety of IORT to those of WBRT as therapeutic options for early-stage breast cancer patients receiving breast-conserving surgery (INPLASY2020120008).MethodsPubMed, Embase, and Cochrane Library databases were searched from inception to October 2021. Computerized and manual searches were adopted to identify eligible randomized control trials from online databases. Risk ratio (RR) and 95% confidence intervals (CI) were calculated by random-effect models to assess the relative risk. Potential publication bias was quantified by Begg’s and Egger’s tests.ResultsBased on our inclusion criteria, 10 randomized control trials involving 5,698 patients were included in this meta-analysis. This meta-analysis showed that the IORT group was associated with a higher local recurrence risk (RR = 2.111, 95% CI, 1.130–3.943, p = 0.0191), especially in the long-term follow-up subgroup or published after 2020 subgroup or Caucasian subgroup (RR = 2.404, 95% CI, 1.183–4.885, p = 0.0154). Subgroup analysis showed that the IORT group had a higher recurrence risk than the WBRT group in the polycentric randomized controlled trial subgroup (RR = 1.213, 95% CI, 1.030–1.428, p = 0.0204). Pooled analysis showed that there was no statistically significant difference in overall survival, recurrence-free survival, distant metastasis-free survival, and cancer-specific survival between IORT and WBRT groups. Additionally, the risk of skin toxicity was reduced, but the incidences of fat toxicity, edema, and scar calcification were significantly increased in the patients who underwent IORT in comparison to those who underwent WBRT.ConclusionThis meta-analysis revealed that IORT was not a better alternative to WBRT. More large-scale and well-designed clinical trials with longer follow-up periods are encouraged to further investigate the value of IORT.Systematic Review Registrationhttps://inplasy.com/inplasy-2020-12-0008/.

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Section: Discussionmentioning

confidence: 99%

Intraoperative Radiotherapy Is Not a Better Alternative to Whole Breast Radiotherapy as a Therapeutic Option for Early-Stage Breast Cancer

et al. 2021

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“…The obvious weakness is that this paper does not describe data about outcomes, but this is not the intention of this manuscript. Outcome data are best gained from comparative analysis within the prospective TARGIT-A randomised trial ( 9 , 10 ), as well as data from several centres that have published their own experience of TARGIT-IORT and from prospective registry studies ( ) ( 18 , 28 , 39 , 55 – 65 ). In addition, as the list of centres using TARGIT-IORT was compiled using personal contacts, we may have missed some centres, underestimating the number of cases.…”

Section: Discussionmentioning

confidence: 99%

Global adoption of single-shot targeted intraoperative radiotherapy (TARGIT-IORT) for breast cancer—better for patients, better for healthcare systems

Vaidya

Baum

et al. 2022

Front. Oncol.

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Micro abstractTargeted intraoperative radiotherapy (TARGIT-IORT) is delivered immediately after lumpectomy for breast cancer. We estimated its impact. At least 44,752 patients with breast cancer were treated with TARGIT-IORT in 260 centres in 35 countries, saving >20 million miles of travel and preventing ~2,000 non–breast cancer deaths. The TARGIT-IORT website (https://targit.org.uk/travel) provides maps and tools to find the nearest centre offering TARGIT-IORT and travel savings.BackgroundTargeted intraoperative radiotherapy (TARGIT-IORT) delivers radiotherapy targeted to the fresh tumour bed exposed immediately after lumpectomy for breast cancer. TARGIT-A trial found TARGIT-IORT to be as effective as whole-breast radiotherapy, with significantly fewer deaths from non–breast cancer causes. This paper documents its worldwide impact and provides interactive tools for clinicians and patients.MethodCentres using TARGIT-IORT provided the date of the first case and the total number of patients. We plotted these data on a customised Google Map. An interactive web-based tool provided directions to the closest centre. Using the data from the TARGIT-A trial, we estimated the total savings in travel miles, carbon footprint, and the number of non–breast cancer deaths that might be prevented.ResultsData from 242 (93%) of the 260 centres treating patients from 35 countries were available. From the first patient treated in 1998 to early 2020, at least 44,752 women with breast cancer have been treated with TARGIT-IORT. The TARGIT-IORT website (https://targit.org.uk/travel) displays the Google Map of centres with number of cases and an interactive tool for patients to find the nearest centre offering TARGIT-IORT and their travel savings. Scaling up to the already treated patients, >20 million miles of travel would have been saved and about 2,000 deaths prevented.ConclusionOne can ascertain the number of patients treated with a novel treatment. These data show how widely TARGIT-IORT has now been adopted and gives an indication of its beneficial worldwide impact on a large number of women with breast cancer.

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“…La població n anciana presenta menores tasas de radiació n adyuvante 17 . Ú nicamente el 79% y el 41% de las pacientes con edad !…”

Section: Discusió Nunclassified

“…80 añ os recibe WBRT tras la CC, respectivamente 18 . Má s aú n en pacientes que viven en á reas rurales, que tienden a presentar mayor edad y el transporte puede resultar una barrera que afecta negativamente la tasa de radiació n adyuvante 17 . Es especialmente en estos casos donde la IORT como monoterapia se presenta como una buena alternativa terapé utica 19 .…”

Section: Discusió Nunclassified

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Radioterapia intraoperatoria en cáncer de mama precoz: análisis observacional frente a radioterapia externa

et al. 2021

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Intraoperative Radiotherapy for Breast Cancer Treatment in a Rural Community

Abstract: For women from rural communities, IORT appears to be an attractive option because these women tend to be older and to live farther from the treatment facility.

Cited by 8 publications

References 31 publications

Intraoperative Radiotherapy Is Not a Better Alternative to Whole Breast Radiotherapy as a Therapeutic Option for Early-Stage Breast Cancer

Intraoperative Radiotherapy Is Not a Better Alternative to Whole Breast Radiotherapy as a Therapeutic Option for Early-Stage Breast Cancer

Global adoption of single-shot targeted intraoperative radiotherapy (TARGIT-IORT) for breast cancer—better for patients, better for healthcare systems

Radioterapia intraoperatoria en cáncer de mama precoz: análisis observacional frente a radioterapia externa

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