Journal
BRITISH JOURNAL OF CANCER
Volume 125, Issue 3, Pages 380-389Publisher
SPRINGERNATURE
DOI: 10.1038/s41416-021-01440-8
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Funding
- University College London Hospitals (UCLH)/UCL Comprehensive Biomedical Research Centre
- UCLH Charities
- National Institute for Health Research (NIHR) Health Technology Assessment programme
- Ninewells Cancer Campaign
- National Health and Medical Research Council
- German Federal Ministry of Education and Research (BMBF) [FKZ 01ZP0508]
- Cancer Research UK
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TARGIT-IORT is as effective as EBRT in all subgroups with a good prognosis for local recurrence after TARGIT-IORT. Non-breast cancer mortality is significantly lower in the TARGIT-IORT arm.
BACKGROUND: The TARGIT-A trial reported risk-adapted targeted intraoperative radiotherapy (TARGIT-IORT) during lumpectomy for breast cancer to be as effective as whole-breast external beam radiotherapy (EBRT). Here, we present further detailed analyses. METHODS: In total, 2298 women (>= 45 years, invasive ductal carcinoma <= 3.5 cm, cN0-N1) were randomised. We investigated the impact of tumour size, grade, ER, PgR, HER2 and lymph node status on local recurrence-free survival, and of local recurrence on distant relapse and mortality. We analysed the predictive factors for recommending supplemental EBRT after TARGIT-IORT as part of the risk-adapted approach, using regression modelling. Non-breast cancer mortality was compared between TARGIT-IORT plus EBRT vs. EBRT. RESULTS: Local recurrence-free survival was no different between TARGIT-IORT and EBRT, in every tumour subgroup. Unlike in the EBRT arm, local recurrence in the TARGIT-IORT arm was not a predictor of a higher risk of distant relapse or death. Our new predictive tool for recommending supplemental EBRT after TARGIT-IORT is at . Non-breast cancer mortality was significantly lower in the TARGIT-IORT arm, even when patients received supplemental EBRT, HR 0.38 (95% CI 0.17-0.88) P = 0.0091. CONCLUSION: TARGIT-IORT is as effective as EBRT in all subgroups. Local recurrence after TARGIT-IORT, unlike after EBRT, has a good prognosis. TARGIT-IORT might have a beneficial abscopal effect.
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