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Is IORT ready for roll-out?
| Content Provider | Europe PMC |
|---|---|
| Author | Esposito, Emanuela Anninga, Bauke Honey, Ian Ross, Gillian Rainsbury, Dick Laws, Siobhan Rinsma, Sygriet Douek, Michael |
| Copyright Year | 2015 |
| Abstract | Two large randomised controlled trials of intraoperative radiotherapy (IORT) in breast-conserving surgery (TARGIT-A and ELIOT) have been published 14 years after their launch. Neither the TARGIT-A trial nor the ELIOT trial results have changed the current clinical practice for the use of IORT. The in-breast local recurrence rate (LRR) after IORT met the pre-specified non-inferiority margins in both trials and was 3.3% in TARGIT-A and 4.4% in the ELIOT trial. In both trials, the pre-specified estimates for local recurrence (LR) with external beam radiation therapy (EBRT) significantly overestimated actual LRR. In the TARGIT-A trial, LR with EBRT was estimated at the outset to be 6%, and in the ELIOT trial, it was estimated to be 3%. Surprisingly, LRR in the EBRT groups has been found to be significantly lower, 1.3% in the EBRT arm of the TARGIT-A and 0.4% in the EBRT arm of the ELIOT trial, respectively. Median follow-up was 2.4 years for the TARGIT-A trial and 5.8 years for the ELIOT trial. However, the initial cohort of patients in the TARGIT-A trial (reported in 2010) now have a median follow-up of 3.8 years and data on LR were available at 5 years follow-up on 35% of patients (18% who received IORT). Although further follow-up will increase confidence with the data, it will also further delay clinical implementation. By carefully weighing the risks and benefits of a single-fraction radiation treatment with patients, IORT should be offered within agreed and strict protocols. Patients deemed at low risk of LR or those deemed suitable for partial breast irradiation, according to the GEC-ESTRO and ASTRO recommendations, could be considered as candidates for IORT. These guidelines apply to all partial breast irradiation techniques, and more specific guidelines for IORT would assist clinicians. |
| Journal | ecancermedicalscience |
| Volume Number | 9 |
| PubMed Central reference number | PMC4360616 |
| PubMed reference number | 25793013 |
| e-ISSN | 17546605 |
| DOI | 10.3332/ecancer.2015.516 |
| Language | English |
| Publisher | Cancer Intelligence |
| Publisher Date | 2015-03-12 |
| Access Restriction | Open |
| Rights License | This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © the authors; licensee ecancermedicalscience. |
| Subject Keyword | breast cancer intraoperative radiotherapy IORT |
| Content Type | Text |
| Resource Type | Article |
| Subject | Oncology Cancer Research |
