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Publications

TARGIT-IORT for breast cancer: Scientific publications

Papers supporting TARGIT-IORT for breast cancer 2023-11-10.jpg

Long-term clinical trial results -1:  British Medical Journal

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Long-term clinical trial results -2: British Journal of Cancer

Long-term clinical trial results - 5 min summary presented at NCRI, UK, Nov 2021

Worldwide centres that have offered TARGIT-IORT for breast cancer
IORT - intraoperative radiation thearpy for breast cancer - better for patient than other PBI approaches
IORT for breast cancer_a_patient-centred_treatment_

TARGIT-IORT is very different from ELIOT 
The Lancet Oncology, July 2021,
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00278-3/fulltext  

"...the long-term breast cancer outcomes (median 9 years, maximum 19 years follow-up) of TARGIT-IORT were similar to the outcomes of whole-breast irradiation. Importantly, most patients in the TARGIT-A trial who had high-risk features (including 78% of patients with grade 3 tumours, 82% of patients with oestrogen receptor-negative tumours, and 63% of patients with node-positive tumours) did not receive supplemental external beam radiotherapy after targeted intraoperative radiotherapy.

TARGIT-IORT vs ELIOT techniques.png

With effective local control, breast cancer mortality with targeted intraoperative radiotherapy is no different from whole-breast irradiation (as shown by the superimposed Kaplan-Meier survival curves), and the reduction in non-breast cancer mortality is substantial: HR 0·59 (95% CI 0·40–0·86; p=0·005), 41% relative risk reduction, and 4·4% in absolute risk reduction (from 9·85% to 5·41% at 12 years).

There are many other benefits to targeted intraoperative radiotherapy. Notably, unlike electron intraoperative radiotherapy, it does not require linear accelerator-style radiation protection. Targeted intraoperative radiotherapy can be done in a standard surgical theatre, has lower toxicity, improved quality of life, superior cosmetic outcomes, and lower health-care costs than whole-breast radiotherapy"
IORT - intraoperative radiotherapy for breast cancer - powerful evidence to change practice

TARGIT literature archive (1995-2018)

First publication of the main results of the TARGIT-A trial

2010    The Lancet.  2010 ;376(9735):91-102.

5-year results and first analysis of survival

2014    The Lancet, 11 November. doi:10.1016/s0140-6736(13)61950-9

Lancet Podcast 

Clinico-Pathological and biological rationale of partial breast irradiation (PBI) and the TARGIT-A Trial

1995    Hongkong International Cancer Congress

1996    British Journal of Cancer

1997    The Lancet

The Core trial Protocol of the Targit-A Trial

1999    The Lancet 

 

The original series of patients treated with intraoperative radiation therapy: the first full paper about Targit IORT technique

2001    Annals of Oncology

 

The surgical technique of targeted intraoperative radiotherapy  (TARGIT) for early breast cancer treatment as used in the Targit trial

 

2002    European Journal of Surgical Oncology

2002    Surgical Technique Video

2006    World Journal of Surgical Oncology (TARGIT IORT given under local anaesthetic)

 

A novel one-stop out-patient treatment for small breast cancers

2002    The Lancet

 

PhD Thesis of Jayant S Vaidya

2002    University College London PhD Thesis

 

Initial media coverage

2000    BBC Tomorrow’s World

2001     Lancet Oncology News

2002    Time Magazine

2003    Reader’s Digest

2006    Reader’s Digest

 

2003 San Antonio Breast Cancer Symposium:30-minute invited presentation about the Targit trial

2003    San Antonio Breast Cancer Symposium - first plenary on TARGIT IORT

Acute and Late Toxicity data about the Targit approach.

2004    ANZ Journal of Surgical Oncology

2005    Oncologie

2005    Tumori

2006    Int J Rad Oncol Biol Phys

2012    Breast Cancer Research and Treatment PDF

 

Reviews, Editorials, Viewpoint and Rebuttals

2004    Lancet Oncology

2004    British Journal of Radiology

2005    Seminas in Radiation Oncology

2006    Clinical Oncology 

2006    The Breast

2007    Nature Clinical Practice Oncology

2008    Annals of New York Academy of Sciences

2015    Red Journal Jun 2015 Pride, Prejudice, or Science: Attitudes Towards the Results of the TARGIT-A Trial of  Targeted Intraoperative Radiation Therapy for Breast Cancer

 

2015    Red Journal Aug 2015- Editorial by the Chief Editor
“…..Many careers have been built around fractionated radiation therapy for breast cancer, and it comprises a substantial proportion of the practice of the average contemporary radiation oncologist. Depending on your perspective, intraoperative radiation therapy is thus either a very serious threat or a quantum leap forward.”

2017    Practical Radiation Oncology February 2017

Commentary and corrections to the 2017 ASTRO - APBI guidelines 

2018   The Lancet 6 Jan 2018 Targeted radiotherapy for breast cancer: Letter |

   Updated meta-analysis of targeted radiotherapy vs whole breast radiotherapy 

2018 BMJ Evidence Based Medicine  Commentary on IMPORT-LOW trial

2018 JAMA Oncology -TARGIT- IORT the best method of partial breast irradiation - an independent opinion

2019 Anticancer research

- TARGIT-IORT in breast cancer patients who had implant augmentation full paperSABCS poster

Meta-analyses confirming that targeted radiotherapy is effective in controlling breast cancer and reduces deaths heart attacks and other cancers

2016     Lancet April 2016

A meta-analysis of GEC-ESTRO + TARGIT-A trials show Partial Breast Irradiation (PBI) has similar breast cancer control as Whole Breast Irradiation (WBI), and fewer deaths from other causes.

2016  Red Journal 13 May 2016
Mortality reduction with Partial Breast Irradiation: A meta-analysis of randomised controlled trials

2018 The Lancet 6 Jan 2018

Updated meta-analysis of targeted radiotherapy vs whole breast radiotherapy 

Targeted radiotherapy for breast cancer: Letter

Environmental and Social impact 

2016     BMJ Open 10 May 2016
TARGIT IORT radiotherapy during lumpectomy for breast cancer could save millions of travel miles & tonnes of CO2. …plus free up thousands of hours for women with early stage breast cancer, every year. 
Video Abstract
Full paper
Press release by the BMJ

2017 J Surg Oncol Nov 2017

The Impact of the Use of Intraoperative Radiotherapy on Costs, Travel Time and Distance for Women With Breast Cancer in the Mexico City Metropolitan Area

Cost-effectiveness of TARGIT 

2013     Annals of Surgical Oncology (PDF)   20:2873–2880

2016     HTA Journals  Health economics - cost effectiveness of TARGIT IORT - PDF 

2017     BMJ Open - PDF

 

Better Cosmetic outcome from TARGIT

2003    San Antonio Breast Cancer Conference 

2013     Breast Cancer Research and Treatment (PDF) 140(3):519-25.

2018     Radiation Oncology 

 

Better Quality of Life with TARGIT

2013    Radiation Oncology

2016    International Journal of Radiation Oncology Biology Physics

Male breast cancer

2017 Breast 

Breast Conservation for Male Breast Cancer: Case Report of Intraoperative Radiation with TARGIT-IORT

Post -IORT changes in the breast

2014 Eur J Surg Oncol

Mammography and Ultraound examination after TARGIT-IORT using Intrabeam: IORT is not detrimental to subsequent radiological follow up.

2017 Breast J

Exuberant Squamous Metaplasia With Calcification Following Intraoperative Radiotherapy for Breast Carcinoma: Report of an Unusual Case and Retrospective Review of Cases From a Single Institution

 

Book Chapters  

2003    Recent Advances in Surgery

2006    Accelerated Partial Breast Irradiation (1st Edition)

2009    Accelerated Partial Breast Irradiation (2nd Edition)

2016     A Short course in breast radiotherapy: Targeted Intraoperative Radiotherapy (TARGIT)

 

Radiobiology of Targeted intraoperation radiation therapy (TARGIT): Mathematical Modelling of breast cancer growth, recurrence and intra-perative radiotherapy (IORT) 

2005    Radiation Research

2005    Cancer Research UK Award Poster

2006    Journal of Theoretical Biology

2007    Journal of Theoretical Biology

Targit boost leading to a very low recurrence rate (5-yr actuarial = 1.73%  – half the expected)

2006    International Journal or Radiation Oncology Biology Physics

2008    American Society of Clinical Oncology (ASCO)

2010     International Journal or Radiation Oncology Biology Physics

Novel effects of TARGIT on tumour micro-environment

2008    Clinical Cancer Research

2009    International Journal of Radiation Oncology Biology Physics

2016     Oncogene: Radiotherapy-induced miR-223 prevents relapse of breast cancer by targeting the EGF pathway.

2017     Systemic Effects of local treatment : Surgery and intraoperative targeted radiotherapy


Full report of TARGIT-A trial comparing Intrabeam TARGIT IORT vs traditional radiotherapy over several weeks for early breast cancer

2016  HTA Journals 

An international randomised controlled trial to compare TARGeted Intraoperative radioTherapy (TARGIT) with conventional postoperative radiotherapy after breast-conserving surgery for women with early-stage breast cancer (the TARGIT-A trial). Vaidya JS, Wenz F, Bulsara M, Tobias JS, Joseph DJ, Saunders C, Brew-Graves C, Potyka I, Morris S, Vaidya HJ, Williams NR, Baum M. Health Technology Assessment 2016;20(73) — PDF download —

 

This contains several additional analyses including a) subgroup analysis as per tumour and patient characteristics b) formal health economic analysis c) analysis of the earliest cohort of patients with a median follow up of 5 years had the same results as the main trial, viz. – that TARGIT and EBRT had similar breast cancer control and non-breast-cancer deaths were fewer with TARGIT.

The publications from 2015-16, after the main results of the TARGIT-A trial were published as well as the initial publications (listed at the end of file) are available in the file:
TARGIT-IORT-with-Intrabeam-Further-evidence-development-2015-16-and-list-of-publications-from-1995-2014.pdf

To read, right-click this Download link to the pdf file, and save the file on your computer.
Then open using Acrobat Reader.
If you cannot see the Bookmarks pane,
click on View profile, then show/hide – navigation panes and then click on Bookmarks.
Now you should see all the 16 bookmarks and navigate through the 16 papers.

To read the list of 66 selected initial original publications please see Publications-between-1995-2014-about-the-TARGIT-IORT-Technique-and-the-TARGIT-trials.pdf The front page of this website has links to the full text PDFs of important publications http://www.targit.org.uk

Lancet 2010 07 09 front page 75dpi.jpg
Adoption and data about TARGIT-IORT from around the world and a patient's view

2014   BMC Cancer Nov 2014
French Study of 12,025 patients: Over 50% of patients having breast conservation are suitable for TARGIT IORT

2015   Breast Surg Mar-Apr 2015
Intraoperative radiotherapy of the breast for early-stage breast cancer: ready for primetime

2015   Br J Surgery May 2015
Intraoperative radiotherapy in early breast cancer

2015  Ecancermedicalscience Mar 2015
Is IORT ready for roll-out? [Yes]

2015  Breast Care 15 July 2015

Accelerated Partial Breast Irradiation in Clinical Practice

2016  Annals of Surgical Oncology 9 May 2016

TARGIT-R (Retrospective): North American Experience [of nearly 1000 patients] with Intraoperative Radiation Using Low-Kilovoltage X-Rays [Intrabeam] for Breast Cancer

Red Journal Jun 2015

2016  Oncology 15 April 2016

[Low] Frequency of Whole-Breast Radiation Therapy Following Intraoperative Radiation Therapy Due to Criteria Identified by Lumpectomy

American J Surg Oct 2016

IORT with its low rate of LR and wound complications may be a reasonable alternative to whole breast irradiation for early-stage breast cancer, regardless of age.

2016   Lancet 7 May 2016:
Intraoperative radiation therapy for breast cancer: a patient’s view

Chapter in “Short Course Breast Radiotherapy” 1 Jan 2016
A Risk-Adapted Approach to Breast Radiation Using Targeted Intraoperative Radiotherapy (TARGIT)

Oncogene 15 Feb 2016
Radiotherapy-induced miR-223 prevents relapse of breast cancer by targeting the EGF pathway.

Oncology 15 April 2016
[Low] Frequency of Whole-Breast Radiation Therapy Following Intraoperative Radiation Therapy Due to Criteria Identified by Lumpectomy

Lancet 23 April 2016
A meta-analysis of GEC-ESTRO + TARGIT-A trials show Partial Breast Irradiation (PBI) has similar breast cancer control as Whole Breast Irradiation (WBI), and fewer deaths from other causes.

Red Journal 30 April 2016
Better Quality of Life with TARGIT

Ann Surg Oncol  2017 
Keynote at American Society of Breast Surgeons

Annals of Surgical Oncology 9 May 2016
TARGIT-R (Retrospective): North American Experience [of nearly 1000 patients] with Intraoperative Radiation Using Low-Kilovoltage X-Rays [Intrabeam] for Breast Cancer

BMJ Open 10 May 2016
TARGIT IORT radiotherapy during lumpectomy for breast cancer could save millions of travel miles & tonnes of CO2. …plus free up thousands of hours for women with early stage breast cancer, every year. 
Video Abstract
Full paper
Press release by the BMJ

Red Journal 13 May 2016
Mortality reduction with Partial Breast Irradiation: A meta-analysis of randomised controlled trials

Over 45,000 women have had TARGIT IORT with Intrabeam for their breast cancer treatment
Worldwide Adoption of Intrabeam TARGIT IORT

A bibliography of scientific literature, evidence, presentations, media coverage related to targeted intraoperative raidiotherapy (TARGIT-IORT) using Intrabeam for breast cancer is being updated here https://bit.ly/TARGIT-IORT-Bibliography

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