Today I shall be giving you the
long-awaited long-term outcomes of the
TARGIT-A trial, a clinical trial to test
whether radiotherapy given only to the
primary tumor [area] is adequate enough for 
cancer control.
patients with breast cancer suitable for
breast conserving surgery with tumors
preferably less than 3 and 1/2
centimeters in size and unifocal on
clinical examination and conventional
imaging with mammography and ultrasound
scan. They had to
have invasive ductal carcinoma proven by
needle biopsy. They were randomly
allocated to receive either TARGIT-IORT
during lumpectomy immediately after
lumpectomy or whole breast radiotherapy
postoperatively. If, when randomized to have
TARGIT-IORT they were found to have
high-risk factors post operatively, they would have
to have whole breast radiotherapy in addition
So you can the tumour bed into which the
applicator is going in and it irradiates
the tissues immediately around the
primary tumor at highest risk of local
recurrence. It happens in the operation
theater between 20 to 40 minutes and it
follows the principle of precision and
immediacy. In the process the organs
nearby such as the heart and the lungs
are protected from unnecessary radiation
Acknowledgments are due to every patient who participated in the trial and all the staff and investigators
who gave all their efforts to make this trial possible
I want to remind you of the
randomization into risk-adapted TARGIT
IORT versus standard conventional
external beam whole breast radiotherapy
and we can see that the patient, tumor
and treatment factors were well matched
in the two randomized arms of the trial
So, for the patient the surgery and
radiotherapy gets completed at the same
time they've got good cosmetic outcome
they have much less pain
and very little chance of a complication
so that's all very good
but the most important question for a
breast cancer patient is what is her
chance of living without the cancer coming back
That is first result that non-inferiority in
terms of local control was confirmed
At complete follow-up of five years, the local recurrence rates
for TARGIT-IORT was 2.11% and for EBRT was 0.95%,
the difference was 1.16%, with upper confidence limit of 1.99%
What about the long term outcomes?
So this is a summary
slide that shows all the important
long-term outcomes - the
local recurrence-free survival is the
same, mastectomy-free survival is the
same, breast cancer mortality is the same
and there's a significant reduction in
non breast cancer mortality by up to
4 percent at 12 years. So the main
conclusions of the TARGIT-A trial are:
compared with EBRT, risk adapted
TARGIT-IORT given during lumpectomy
achieves comparable cancer control
outcomes in the long term. Secondly it
reduces non breast cancer mortality as
well.
TARGIT-IORT has substantial advantages
the patient in the healthcare system
it's convenient it is less painful it
has better cosmetic outcome and improved
quality of life
it takes less time less travel and
the cost is lower both to the healthcare
system as well as the patient.
Eligible patients should be offered this one-stop
treatment of TARGIT-IORT during
lumpectomy and it should be discussed with
them before they have the operation
Thank you very much... [The following slides show important citations / references and acknowledgments]
