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Pr Jayant S Vaidya and Michael Baum: Intraoperative radiotherapy for breast cancer

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INTRAOPERATIVE RADIOTHERAPY FOR BREAST CANCER

 

Intraoperative radiotherapy at the time of lumpectomy is as effective as whole breast irradiation and associated with fewer non-cancer deaths

 

 

Professor Jayant S Vida:

Local control of breast cancer and breast cancer mortality is similar to whole breast radiation and there are significantly fewer deaths from other causes, such as cardiovascular disease and other cancers.

 

PETER:

Intraoperative radiotherapy given at the time of lumpectomy has been compared with standard whole breast irradiation in the randomized TARGIT A trial published in the Lancet now reporting five year follow up.

 

Professor Jayant S Vida:

After lumpectomy is done, we insert a spherical applicator to give radiotherapy to the tissues immediately surrounding the tumor, and it is done in about 20-30 minutes in a standard operating theatre and this is done during lumpectomy under the same anesthetic, we close the wound and that is the end of it.

 

PETER:

3500 women were randomized and any patients in the experimental arm who were found, at surgery, to be at higher risk received supplementary external irradiation in addition to their intraoperative therapy.

 

Professor Jayant S Vida:

In terms of deaths we found that breast cancer deaths were similar in the two groups, but deaths from other causes, such as cardiovascular causes and other cancers, were significantly lower in the group that received TARGIT compared to those that received external beam radiotherapy. Suitable patients would be able to have their whole local treatment at one time in the operation theatre.

 

Professor Michael Baum:

For women who meet the entry criteria as described in the TARGIT trial, and understanding that a minority, about 15%, may then need additional top up treatment, we can confidently say that this approach is no worse than whole breast irradiation and when it comes toxicity, tolerability and cosmetic outcome, it’s a little better.

 

Professor Jayant S Vida:

For a basic cancer doctor it means for example a radiotherapy centre, it means it frees up resources for treating other cancers, it also means for a busy health care system that it will save money.

 

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