A new study has demonstrated that a 30-minute radiotherapy administered intraoperatively could be as effective as existing conventional therapy procedures.
The technology has been available in the United Kingdom's National Health Service (NHS) since 2018, with studies on its environmental and social benefits being studied as early as 2016. However, an article from the British publication Daily Mail reports that many doctors do not actively prescribe the procedure, explaining that they await further studies.
The international study is published on The BMJ website on Wednesday, August 19, 2020.
Targeted Intraoperative Radiotherapy (TARGIT-IORT)
The novel breast cancer treatment, called targeted intraoperative radiotherapy, is a technique to introduce radiotherapy to tissues that surround cancerous cells after being removed by surgery. It uses a miniature and mobile X-ray source, which ends in a ball-shaped tip inserted inside the affected breast after the operation.
An international team of researchers, led by Jayant S. Vaidya, Professor of Surgery and Oncology at the Division of Surgery and Interventional Science at University College London, studied the effect of the procedure across 32 centers in the US, UK, Australia, and seven other countries around the world.
Their study covered 2,298 female participants aged 45 years old or older and was eligible for breast conservation surgery (BCS)—a standard part of breast cancer treatment plans involving the removal of the specific part of the breast infected with cancer. The study lasted from March 24, 2000, until June 25, 2012.
Half of the participants (1158 women) were subjected to external beam radiotherapy (EBRT), which is the conventional method. The randomly allocated participants in the EBRT arm included a standard daily course of whole breast radiotherapy, lasting for up to six weeks.
The other half, comprising 1140 women, were assigned to receive the TARGIT-IORT, receiving a single session of the intraoperative radiotherapy.
No Significant Difference Between The Two Methods
The participants from both arms were then monitored by the researchers for the next five years to see if there were noticeable differences in the two arms. Results show that TARGIT-IORT was "non-inferior" compared to EBRT.
In the first five years, researchers noted that the local recurrence risk after the five-year follow-ups were 2.11 percent for TARGIT-IORT and 0.95 percent for EBRT. Furthermore, in the first five years, researchers observed 13 additional recurrences - 24 cases for TARGIT-IORT and 11 for EBRT. However, there were fewer deaths from the TARGIT-IORT group (42 deaths) compared to the EBRT group (56 deaths).
Citing the data from long-term follow-ups, the researchers observed that there was no longer any statistically significant difference between the two groups - with the criteria including local recurrence-free survival, distant disease-free survival, mastectomy-free survival, overall survival, and breast cancer mortality.
With the data from the study, the research team now states that "TARGIT-IORT should be discussed with eligible patients" when discussing breast-conserving surgery as a treatment option.
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