TARGIT-R (Retrospective): 5-Year Follow-Up Evaluation of Intraoperative Radiation Therapy (IORT) for Breast Cancer Performed in North America

Stephanie A. Valente*, Rahul D. Tendulkar, Sheen Cherian, Chirag Shah, Darrel L. Ross, S. Chace Lottich, Christine Laronga, Kristy K. Broman, Eric D. Donnelly, Kevin P. Bethke, Christina Shaw, Natalie A. Lockney, Aaron Pederson, Ray Rudolph, Michael Hasselle, Pond Kelemen, Ulrich Hermanto, Andrew Ashikari, Song Kang, Richard A. HoeferDavid McCready, Anthony Fyles, Jamie Escallon, Nitin Rohatgi, Jeannine Graves, Gregory Graves, Shawna C. Willey, Eleni Tousimis, Lee Riley, Nimisha Deb, Chao Tu, William Small, Stephen R. Grobmyer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background: Intraoperative radiation therapy (IORT) has been investigated for patients with low-risk, early-stage breast cancer. The The North American experience was evaluated by TARGIT-R (retrospective) to provide outcomes for patients treated in “real-world” clinical practice with breast IORT. This analysis presents a 5-year follow-up assessment. Methods: TARGIT-R is a multi-institutional retrospective registry of patients who underwent lumpectomy and IORT between the years 2007 and 2013. The primary outcome of the evaluation was ipsilateral breast tumor recurrence (IBTR). Results: The evaluation included 667 patients with a median follow-up period of 5.1 years. Primary IORT (IORT at the time of lumpectomy) was performed for 72%, delayed IORT (after lumpectomy) for 3%, intended boost for 8%, and unintended boost (primary IORT followed by whole-breast radiation) for 17% of the patients. At 5 years, IBTR was 6.6% for all the patients, with 8% for the primary IORT cohort and 1.7% for the unintended-boost cohort. No recurrences were identified in the delayed IORT or intended-boost cohorts. Noncompliance with endocrine therapy (ET) was associated with higher IBTR risk (hazard ratio [HR], 3.67). Patients treated with primary IORT who were complaint with ET had a 5-year IBTR rate of 3.9%. Conclusion: The local recurrence rates in this series differ slightly from recent results of randomized IORT trials and are notably higher than in previous published studies using whole-breast radiotherapy for similar patients with early-stage breast cancer. Understanding differences in this retrospective series and the prospective trials will be critical to optimizing patient selection and outcomes going forward.

Original languageEnglish (US)
Pages (from-to)2512-2521
Number of pages10
JournalAnnals of surgical oncology
Issue number5
StatePublished - May 2021

ASJC Scopus subject areas

  • Surgery
  • Oncology


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