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Strategy is alternative to whole breast radiotherapy delivered over several weeks

-- Rick Ansorge

Monday, June 7, 2010 (Last Updated: 06/08/2010)

MONDAY, June 7 (HealthDay News) -- In women ages 45 and older with early invasive breast cancer who are undergoing breast-conserving surgery, a single dose of targeted intraoperative radiotherapy may be as effective at preventing breast cancer recurrences as several weeks of conventional whole breast radiotherapy, according to a study published online June 5 in The Lancet to coincide with a presentation at the 46th Annual Meeting of the American Society of Clinical Oncology, held from June 4 to 8 in Chicago.

Jayant S. Vaidya, Ph.D., of the University College London, and colleagues from the targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A) trial conducted a prospective, randomized, non-inferiority trial which assigned 1,113 women to receive targeted intraoperative radiotherapy and 1,119 women to receive external beam radiotherapy.

After a four-year follow-up, the researchers found that local recurrence rates were similar in the intraoperative radiotherapy and external beam radiotherapy groups (1.20 and 0.95 percent, respectively; P = 0.41). They also found that the rates of major toxicity were similar in both groups (3.3 and 3.9 percent, respectively; P = 0.44), and that the rate of radiotherapy toxicity (Radiation Therapy Oncology Group grade 3) was lower in the targeted intraoperative radiotherapy group than in the external beam radiotherapy group (0.5 versus 2.1 percent, respectively; P = 0.002).

"We still await long-term follow-up and the results of another randomized trial from the National Surgical Adjuvant Breast and Bowel Project B-39," state the authors of an accompanying comment. "Nevertheless, in elderly patients, we are already convinced that accelerated partial-breast irradiation is the new standard and intraoperative radiotherapy an excellent approach."

Several authors disclosed financial relationships with Carl Zeiss, manufacturer of the Intrabeam device, and one author disclosed previously receiving a grant from Photoelectron Corp.

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