About TARGIT-IORT Treatment
For many patients, TARGIT-IORT completely eliminates the need for the 3- to 6-week course of traditional external beam radiation normally required after lumpectomy. TARGIT was shown to be as safe as whole breast radiotherapy in a large, prospective randomized international study called the TARGIT-A Trial. More importantly, breast cancer survival was equal between the two treatments and deaths related to heart disease and other cancers were significantly lower among women receiving TARGIT-IORT.
Traditional external beam radiation therapy involves treating the entire breast from the “outside-in,” carefully directing the radiation therapy to the breast rather than the surrounding tissues. The proximity of the heart and lungs and skin limit the dose of radiation that can be given at any one time, leading to a prolonged treatment course. IORT targets the dose from the “inside-out” at the time of surgery, precisely where it is needed. This allows a much higher dose to be given at one time, avoiding irradiation of vital adjacent organs such as the lungs and heart.
These images demonstrate the difference between IORT and traditional external radiation. In the image on the left, the tumor bed receives a single dose of radiation administered inside the breast immediately after the tumor has been surgically removed. This dose only affects a 1-2cm area directly surrounding where the tumor was located, potentially destroying any remaining cancer cells while leaving the rest of the breast and neighboring tissues unharmed.
In the image on the right, as many as 30 doses of radiation are directed at the entire breast from outside the breast during the course of several weeks following the patient’s lumpectomy. While these treatments effectively administer radiation to the tumor site, they can also adversely affect the rest of the breast and surrounding tissues, including the skin and chest wall, as well as the nearby organs such as the heart and lung.
Intraoperative Radiotherapy Q & A
What is targeted intraoperative radiotherapy?
Targeted Intraoperative radiotherapy (TARGIT-IORT) is a form of breast radiation that is administered as a single treatment at the same time as the lumpectomy to reduce the risk of cancer recurrence. As a type of partial breast irradiation, TARGIT limits the radiation treatment to the tumor site where the risk of recurrence is highest. This spares the rest of the breast and surrounding tissues (e.g., heart and lung) the side effects of radiation. TARGIT-IORT takes only about 30 minutes to deliver. By comparison, traditional whole breast radiotherapy administers radiation to the whole breast, chest wall, and to some degree the nearby organs, and takes several weeks to complete.
What are the advantages of TARGIT-IORT versus traditional radiotherapy?
For most patients, TARGIT-IORT completely eliminates the need for the 3- to 6- week course of whole breast radiation normally required after lumpectomy surgery. Also, TARGIT-IORT reduces the overall side effects of radiation by limiting the radiation dose to the part of the breast where the cancer was just removed, sparing the rest of the breast and surrounding tissues (e.g., heart and lung) the side effects of radiation.
Is TARGIT-IORT an effective treatment for breast cancer?
The effectiveness of TARGIT-IORT was investigated in a prospective, randomized, international study called the TARGIT-A Trial, a clinical trial that compared partial breast single dose targeted intraoperative radiotherapy (TARGIT-IORT) to 3 to 6 weeks of post-operative whole breast radiotherapy among women undergoing lumpectomy for early stage invasive ductal breast cancer. The clinical trial demonstrated essentially equal breast cancer recurrence rates and equal cancer survival rates among recipients of targeted IORT during lumpectomy compared to those receiving multiple weeks of whole breast radiation after lumpectomy. The paper was published in the British Medical Journal.
With long term follow-up (median 8.6 years, maximum 18.9 years), the TARGIT-A Trial demonstrated no significant difference in the 5- year local recurrence rates and 8.6 year local recurrence-free survival rate, breast cancer survival rate, and overall survival rate. Women receiving targeted IORT had a significantly lower risk of dying from other causes (e.g., heart disease or other cancers).
Am I a candidate for TARGIT-IORT?
If you’ve been diagnosed with breast cancer and are considering a lumpectomy, you may be eligible for TARGIT-IORT if you meet the following criteria:
- Age 45 or older
- Have breast cancer in only one part of the breast
- Have breast cancer treatable with lumpectomy
- Have a tumor that is 3 cm (1.5 inches) or smaller
- Don’t have any signs of cancer in the lymph nodes
- Have stage 1 or early stage 2 invasive ductal carcinoma of the breast
Is TARGIT-IORT safe?
TARGIT-IORT was shown to be as safe as traditional whole breast radiotherapy in a large, international study called the TARGIT-A Trial. More importantly, breast cancer survival was equal between the two treatments and deaths related to heart disease and other cancers were significantly lower among women receiving TARGIT-IORT.