Professor Vaidya added: "These new results make it clear that the TARGIT-IORT is effective in all tumour subgroups of invasive duct cancer, the most common type of breast cancer. Our new online tool can help clinicians make a decision about additional radiotherapy (recommended in a small proportion of cases) for each individual patient.
"The finding that fewer deaths are from the avoidance of scattered radiation and the possible abscopal effect of TARGI-IORT is important and should fuel further research, opening doors to new treatments."
For the clinical trial, which started in March 2000, 2,298 women aged 45 or over with invasive breast cancer and a tumour up to 3.5cm in diameter were randomly assigned to receive either TARGIT-IORT during lumpectomy or post-operative EBRT.
The trial was designed and run from UCL, involved 32 hospitals and medical centres in ten countries: the UK, France, Germany, Italy, Norway, Poland, Switzerland, the USA, Canada and Australia.
Professor Michael Baum (UCL Surgery & Interventional Science) said: These results are the highest level of evidence proving not only the effectiveness of TARGIT-IORT but confirming that it avoids deaths from other causes.
"The new data is biologically very interesting and the new tools will make its application in routine clinical practice much easier. I am pleased that it will benefit thousands of breast cancer patients around the world."
Professor Jeffrey S Tobias (Professor of Clinical Oncology, UCL and UCLH) said: With "TARGIT-IORT, the majority of patients presenting with early localised breast cancer will never need any further radiotherapy.
"They will avoid all the side effects of whole breast radiotherapy. The chance of remaining free of local recurrence (in the breast itself) is the same as with traditional treatment, but our new analysis shows that even if they do get a local relapse, it will not detract from an excellent prognosis - as good as not having a relapse - a rather different state of affairs from the more serious outlook if this were to happen after EBRT."
To date, 45,000 patients in 260 centres in 38 countries have received TARGIT-IORT). The clinicians hope that following the latest results, more patients can be offered the treatment both in the UK and around the world instead of EBRT.
Jayant S. Vaidya, Max Bulsara, Michael Baum, Frederik Wenz, Samuele Massarut, Steffi Pigorsch, Michael Alvarado, Michael Douek, Christobel Saunders, Henrik Flyger, Wolfgang Eiermann, Chris Brew-Graves, Norman R. Williams, Ingrid Potyka, Nicholas Roberts, Marcelle Bernstein, Douglas Brown, Elena Sperk, Siobhan Laws, Marc Sütterlin, Tammy Corica, Steinar Lundgren, Dennis Holmes, Lorenzo Vinante, Fernando Bozza, Montserrat Pazos, Magali Le Blanc-Onfroy, Günther Gruber, Wojciech Polkowski, Konstantin J. Dedes, Marcus Niewald, Jens Blohmer, David McReady, Richard Hoefer, Pond Keleman, Gloria Petralia, Mary Falzon, David Joseph, Jeffrey S. Tobias, 'New clinical and biological insights from the international TARGIT-A randomised trial of targeted intraoperative radiotherapy during lumpectomy for breast cancer' is published in British Journal of Cancer.
The DOI for this paper is https://doi.org/10.1038/s41416-021-01440-8
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