TARGIT-R (Retrospective): North American Experience with Intraoperative Radiation Using Low-Kilovoltage X-Rays for Breast Cancer

Stephanie A. Valente*, Rahul D. Tendulkar, Sheen Cherian, Colin O’Rourke, Jon M. Greif, Lisa Bailey, Valery Uhl, Kevin P. Bethke, Eric D. Donnelly, Ray Rudolph, Aaron Pederson, Thomas Summer, S. Chace Lottich, Darrel L. Ross, Christine Laronga, Loretta Loftus, Andrea M. Abbott, Pond Kelemen, Ulrich Hermanto, Neil B. FriedmanGauri C. Bedi, Jennifer E. Joh, William A. Thompson, Richard A. Hoefer, Jason P. Wilson, Song K. Kang, Barry Rosen, James Ruffer, Luis Bravo, Alice Police, Jamie M. Escallon, Anthony W. Fyles, David R. McCready, Gregory M. Graves, Nitin Rohatgi, Joyce A. Eaker, Jannine Graves, Shawna C. Willey, Eleni A. Tousimis, Brian T. Collins, Christina M. Shaw, Lee Riley, Nimisha Deb, Tricia Kelly, David L. Andolino, Marc E. Boisvert, Joanne Lyons, William Small, Stephen R. Grobmyer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Background: Single-dose intraoperative radiotherapy (IORT) is an emerging treatment for women with early stage breast cancer. The objective of this study was to define the frequency of IORT use, patient selection, and outcomes of patients treated in North America. Methods: A multi-institutional retrospective registry was created, and 19 institutions using low-kilovoltage IORT for the treatment of breast cancer entered data on patients treated at their institution before July 31, 2013. Patient selection, IORT treatment details, complications, and recurrences were analyzed. Results: From 2007 to July 31, 2013, a total of 935 women were identified and treated with lumpectomy and IORT. A total of 822 patients had at least 6 months’ follow-up documented and were included in the analysis. The number of IORT cases performed increased significantly over time (p < 0.001). The median patient age was 66.8 years. Most patients had disease that was <2 cm in size (90 %) and was estrogen positive (91 %); most patients had invasive ductal cancer (68 %). Of those who had a sentinel lymph node procedure performed, 89 % had negative sentinel lymph nodes. The types of IORT performed were primary IORT in 79 %, secondary IORT in 7 %, or planned boost in 14 %. Complications were low. At a median follow-up of 23.3 months, crude in-breast recurrence was 2.3 % for all patients treated. Conclusions: IORT use for the treatment of breast cancer is significantly increasing in North America, and physicians are selecting low-risk patients for this treatment option. Low complication and local recurrence rates support IORT as a treatment option for selected women with early stage breast cancer.

Original languageEnglish (US)
Pages (from-to)2809-2815
Number of pages7
JournalAnnals of surgical oncology
Volume23
Issue number9
DOIs
StatePublished - Sep 1 2016

ASJC Scopus subject areas

  • Surgery
  • Oncology

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