In the last 18 months further evidence has emerged supporting the use of TARGIT IORT for breast cancer.
The Full Report of the TARGIT-A trial was published in the HTA Journals in September 2016.
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.
HTA Journals 18 June 2016
Full report of TARGIT-A trial comparing Intrabeam TARGIT IORT vs traditional radiotherapy over several weeks for early breast cancer
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 —
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:
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
The list is also shown below:
Further evidence supporting adoption TARGIT IORT in routine clinical practice:
16 publications in major journals the last 18 months from USA, Europe and Australia
2. Breast Surg Mar-Apr 2015
Intraoperative radiotherapy of the breast for early-stage breast cancer: ready for primetime
3. Br J Surgery May 2015
Intraoperative radiotherapy in early breast cancer
4. Ecancermedicalscience Mar 2015
Is IORT ready for roll-out? [Yes]
Red Journal Aug 2015- Editorial by the Red Journal
“…..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.”
6. Breast Care 15 July 2015
Accelerated Partial Breast Irradiation in Clinical Practice
8. Chapter in “Short Course Breast Radiotherapy” 1 Jan 2016
A Risk-Adapted Approach to Breast Radiation Using Targeted Intraoperative Radiotherapy (TARGIT)
9. Oncogene 15 Feb 2016
Radiotherapy-induced miR-223 prevents relapse of breast cancer by targeting the EGF pathway.
11. 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.
12. Red Journal 30 April 2016
Better Quality of Life with TARGIT
13. Lancet 7 May 2016:
Intraoperative radiation therapy for breast cancer: a patient’s view
14. 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
15. 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.
Press release by the BMJ
16. Red Journal 13 May 2016
Mortality reduction with Partial Breast Irradiation: A meta-analysis of randomised controlled trials
An estimated 20,000 patients have already been treated with Intrabeam TARGIT IORT
Worldwide Adoption of Intrabeam TARGIT IORT
“Our meta-analysis of 5-year data from published randomized trials of partial breast irradiation (PBI, alone or within a risk-adapted approach) vs. whole breast irradiation (WBI) for invasive breast cancer treated with lumpectomy, found no difference in breast cancer mortality (n=4489,difference 0.000%(95%CI -0.7 to +0.7),p=0.972). PBI was better than WBI for non-breast cancer mortality (n=4231,difference 1.1% (95%CI -2.1% to -0.2%),p=0.023), and total mortality (difference 1.3% (95%CI -2.5% – 0.0%),p=0.05), leading to a 25% relative risk reduction.”
In the figure below, PBI means Partial Breast Irradiation i.e., radiation only to the area near the tumour rather than the whole breast (Whole Breast Irradiation WBI).
The red diamond shows the overall effect from several trials with over 4000 patients. If the diamond sits on the vertical line, it means there is no effect – and if it is on the left it means that treatment is better for the patient.
So PBI (using TARGIT IORT as a single shot radiation at the time of lumpectomy for breast cancer, for example) reduces mortality, possibly by avoiding irradiation of vital organs, while maintaining cancer control.
If the above does not play properly, you can view it on YouTube:
Full paper can be accessed at:
25 July 2014 : NICE issued a press release that prompted the following media coverage of TARGIT IORT for breast cancer with Intrabeam
TARGIT IORT for breast cancer using Intrabeam – TV / Radio News and Interviews with Professor Jeffrey Tobias and Professor Jayant VaidyaIndividual Clips
BBC Radio 4: The Today Programme
Sophie Hutchinson reports
Interview with Professor Jeffrey Tobias
ITV Evening News
Daily Mail – Jul 24, 2014
News Articles on TV channels
Marcelle Bernstein talks about the pioneering breast cancer treatment she received two years ago which is to be offered on the NHS.
Health / 25 July 2014
A pioneering breast cancer treatment that replaces weeks of radiotherapy with a single, targeted shot is set to be offered on the NHS. The dose…
Click to access the PDF file: Adequacy of follow up duration in TARGIT-A trial of targeted intraoperative radiotherapy for breast cancer
Adequacy of follow up duration in the TARGIT-A trial
In this short paper, we provide a detailed explanation about the follow-up of the TARGIT-A trial[1, 2] and clarify how it is long enough to be relied upon to guide the application of TARGIT using Intrabeam in routine clinical practice in appropriate patients. We have explained this in the correspondence columns of the Lancet (17 May 2014)
It may appear tempting to speculate that years in the future a difference in local recurrence will become apparent and the difference in mortality that we have already seen will go away, but neither our data nor previous trial results support this speculation, which ignores our understanding about the complex natural history of breast cancer and robust literature about the toxic effects of EBRT on other organs such as the heart.
Continuing to ignore the TARGIT-A trial data can potentially put a large proportion of breast cancer patients at a significant disadvantage. Continue reading
TARGIT-A and TARGIT-B trials: Invited talk at the American Brachytherapy Society meeting, Las Vegas, Oct 2013
Case selection for TARGIT using hormone receptor status:
Three papers were presented at ASTRO in Sepemeber 2013: two posters and one oral presentation.
TARGIT at the consensus meeting, St Gallen Breast Cancer symposium, March 2011
19 March 2011
At the 12th International St.Gallen Breast Cancer Conference 16-19 March 2011 / St.Gallen, Switzerland,(~4200 delegates) at the Consensus session on the last day of the conference voted in favour of using intraoperative radiotherapy.
The first full paper about TARGIT was published in 2001 Continue reading