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Emanuela Esposito, Michael Douek
Intraoperative radiotherapy (IORT) for breast cancer has challenged the standard external beam radiotherapy (EBRT) and has been shown to be non-inferior for treating early breast cancer in the past decade. Several technologies have been tested for IORT and various randomised controlled trials are still ongoing. Different methods of application of IORT have also been evaluated, from early breast cancer to tumour bed boost radiotherapy amongst high risk women. TARGIT-A and ELIOT trials have reported a low incidence of local recurrence and good survival in both arms...
2018: Ecancermedicalscience
Christina Hedin, Rune Sjödahl, Åke Aldman, Thomas Davidsson, Ann-Sofie Kammerlind, Måns Agrup, Elvar Theodorsson
The TARGIT-A (TARGeted Intraoperative radioTherapy) multicentre study of early breast cancer compared intraoperative radiotherapy with external radiotherapy. While the intraoperative radiotherapy was standardised, the external postoperative comparison treatment followed established routines in the participating treatment centres resulting in substantial variations in dosages and treatment durations. The uncertainties in the interpretation of the study results created by the design of the TARGIT-A study constitute substantial obstacles to the possible introduction of intraoperative radiotherapy for early breast cancer...
January 26, 2018: Läkartidningen
Hans-Christian Kolberg, György Lövey, Leyla Akpolat-Basci, Miltiades Stephanou, Peter Fasching, Michael Untch, Oliver Hoffmann, Max Bulsara, Jayant Vaidya, Cornelia Liedtke
Introduction: In a previous study our group showed a beneficial effect of targeted intraoperative radiotherapy (TARGIT-IORT) as an intraoperative boost on overall survival after neoadjuvant chemotherapy (NACT) compared to an external boost (EBRT). In this study we present the results of a detailed subgroup analysis of the hormone receptor (HR)-positive HER2-negative patients. Methods: In this cohort study involving 46 patients with HR-positive HER2-negative breast cancer after NACT, we compared the outcomes of 21 patients who received an IORT boost to those of 25 patients treated with an EBRT boost...
October 2017: Breast Care
Hung-Wen Lai, Liang-Chih Liu, Fu Ouyang, Chung-Chin Yao, Hsiang-Chun Jan, Ya-Herng Chang, Chi-Wen Tu, Dar-Ren Chen, Tsui-Fen Cheng, Yen-Dun Tzeng, Huan-Ming Hsu, Ming-Hsin Yeh, Yao-Chung Wu, Po-Sheng Yang, Hung-Bun Lam, Ming-Feng Hou, Fang-Ming Chen
BACKGROUND: In this multi-center study, we report the patient selection criteria for and preliminary oncologic outcomes associated with intraoperative radiotherapy (IORT) delivered by the Xoft Axxent® eBx® system for early-stage breast cancer in Taiwan. METHODS: Patients with early breast cancer in Taiwan received breast conserving surgery and received IORT with Xoft Axxent® eBx® System during 2013-2015 was search from database of Taiwan IORT study cooperative group (T-IORTSCG)...
2017: PloS One
Yaseen Saleh, Hualin Zhang
PURPOSE: To characterize the dosimetric impact of using different sizes of spherical applicators in Intrabeam™ Intraoperative Radiation Therapy (IB-IORT) to treat unicentric cancer lesions after breast-conserving lumpectomy. METHODS: Using the commissioned depth dose rates, the three-dimensional dosages of the 3.5, 4.0, 4.5, and 5.0 cm spherical applicators of the IB-IORT PRS400 machine were established. Five different cancer cell infiltration depths of unicentric breast lesions were formulated by a linearly declining cancer cell density distribution from the surgical surface...
December 2017: Medical Physics
Karen C Johnson, Fridtjof Thomas, Phyllis Richey, Quynh T Tran, Fran Tylavsky, Danielle Miro, Mace Coday
OBJECTIVE: To evaluate whether a behavioral weight management program combined with a smoking cessation program delivered via interactive technology could prevent postcessation weight gain. METHODS: Three hundred and thirty young adult smokers, age 18 to 35 years, were randomized to a smoking cessation program alone (comparison group), which included behavioral counseling and nicotine replacement, or to a behavioral weight management program adapted from the Look AHEAD trial plus the same smoking cessation program (intervention group)...
October 2017: Obesity
Anil Vaidya, Param Vaidya, Brigitte Both, Chris Brew-Graves, Max Bulsara, Jayant S Vaidya
OBJECTIVE: The clinical effectiveness of targeted intraoperative radiotherapy (TARGIT-IORT) has been confirmed in the randomised TARGIT-A (targeted intraoperative radiotherapy-alone) trial to be similar to a several weeks' course of whole-breast external-beam radiation therapy (EBRT) in patients with early breast cancer. This study aims to determine the cost-effectiveness of TARGIT-IORT to inform policy decisions about its wider implementation. SETTING: TARGIT-A randomised clinical trial (ISRCTN34086741) which compared TARGIT with traditional EBRT and found similar breast cancer control, particularly when TARGIT was given simultaneously with lumpectomy...
August 17, 2017: BMJ Open
Melvin J Silverstein, Melinda S Epstein, Kevin Lin, Peter Chen, Sadia Khan, Lincoln Snyder, Lisa E Guerra, Cristina De Leon, Ralph Mackintosh, Colleen Coleman, January Lopez, Brian Kim
INTRODUCTION: Two prospective, randomized trials, TARGIT-A and ELIOT, have shown intraoperative radiation therapy (IORT) to be a safe alternative to whole breast radiation therapy following breast-conserving surgery for selected low-risk patients. However, minimal data are available about the clinical effectiveness of this modality of treatment using the Xoft® Axxent® Electronic Brachytherapy (eBx® ) System® . METHODS: A total of 201 patients with 204 early-stage breast cancers were enrolled in a prospective X-ray IORT trial from June 2010 to September 2013...
October 2017: Annals of Surgical Oncology
Hans-Christian Kolberg, Gyoergy Loevey, Leyla Akpolat-Basci, Miltiades Stephanou, Peter A Fasching, Michael Untch, Max Bulsara, Jayant S Vaidya, Cornelia Liedtke
INTRODUCTION: Targeted intraoperative radiotherapy (TARGIT - IORT) as a tumour bed boost after breast conserving surgery is well established for women with early breast cancer. A previous study from our group shows a beneficial effect of TARGIT-IORT on overall survival (OS) but not disease-free survival (DFS) after neoadjuvant chemotherapy compared to an external boost suggesting a potential non-inferiority of TARGIT-IORT. In this study, we present results regarding the high-risk subset of patients (i...
2017: Reviews on Recent Clinical Trials
Felix Sedlmayer, Roland Reitsamer, Frederik Wenz, Elena Sperk, Christoph Fussl, Julia Kaiser, Ingrid Ziegler, Franz Zehentmayr, Heinz Deutschmann, Peter Kopp, Gerd Fastner
The term IORT (intraoperative radiotherapy) is currently used for various techniques that show huge differences in dose delivery and coverage of the tissue at risk. The largest evidence for boost IORT preceding whole breast irradiation (WBI) originates from intraoperative electron treatments (IOERT) with single doses around 10 Gy. At median follow-up periods at 6 years, outstandingly low local recurrence rates of less than 1% are observed. Higher local relapse rates were described for G3 tumors and triple negative breast cancers as well as for IORT following primary systemic treatment for locally advanced tumors...
January 19, 2017: Radiation Oncology
Hans-Christian Kolberg, Gyoergy Loevey, Leyla Akpolat-Basci, Miltiades Stephanou, Peter A Fasching, Michael Untch, Cornelia Liedtke, Max Bulsara, Jayant S Vaidya
INTRODUCTION: The use of targeted intraoperative radiotherapy (TARGIT-IORT) as a tumour bed boost during breast-conserving surgery (BCS) for breast cancer has been reported since 1998. We present its use in patients undergoing breast conservation following neoadjuvant therapy (NACT). METHOD: In this retrospective study involving 116 patients after NACT we compared outcomes of 61 patients who received a tumour bed boost with IORT during lumpectomy versus 55 patients treated in the previous 13 months with external (EBRT) boost...
January 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Eric Lambaudie, Gilles Houvenaeghel, Amira Ziouèche, Sophie Knight, François Dravet, Jean Remy Garbay, Sylvie Giard, Hélène Charitansky, Monique Cohen, Christelle Faure, Delphine Hudry, Paul Azuar, Richard Villet, Pierre Gimbergues, Christine Tunon de Lara, Agnès Tallet, Marie Bannier, Mathieu Minsat, Michel Resbeut
BACKGROUND: To estimate the proportion of elderly patients (>70 years) with breast cancer eligible for an Exclusive IntraOperative RadioTherapy (E-IORT) and to evaluate their local recurrence-free survival rate. METHODS: This retrospective study examining two cohorts focuses on patients over 70 years old: a multi-centric cohort of 1411 elderly patients and a mono-centric cohort of 592 elderly patients. All patients underwent conservative surgery followed by external radiotherapy for T0-T3 N0-N1 invasive breast cancer, between 1980 and 2008...
November 15, 2016: BMC Surgery
Jayant S Vaidya, Frederik Wenz, Max Bulsara, Jeffrey S Tobias, David J Joseph, Christobel Saunders, Chris Brew-Graves, Ingrid Potyka, Stephen Morris, Hrisheekesh J Vaidya, Norman R Williams, Michael Baum
BACKGROUND: Based on our laboratory work and clinical trials we hypothesised that radiotherapy after lumpectomy for breast cancer could be restricted to the tumour bed. In collaboration with the industry we developed a new radiotherapy device and a new surgical operation for delivering single-dose radiation to the tumour bed - the tissues at highest risk of local recurrence. We named it TARGeted Intraoperative radioTherapy (TARGIT). From 1998 we confirmed its feasibility and safety in pilot studies...
September 2016: Health Technology Assessment: HTA
F Wenz
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Y Abo-Madyan, G Welzel, E Sperk, C Neumaier, A Keller, S Clausen, F Schneider, M Ehmann, F Wenz
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Tammy Corica, Anna K Nowak, Christobel M Saunders, Max Bulsara, Mandy Taylor, Jayant S Vaidya, Michael Baum, David J Joseph
PURPOSE: To report the first comprehensive investigation of patient-reported cosmesis and breast-related quality of life (QOL) outcomes comparing patients randomized to risk-adapted single-dose intraoperative radiation therapy (TARGIT-IORT) versus external beam radiation therapy (EBRT) on the TARGIT-A trial. METHODS AND MATERIALS: Longitudinal cosmesis and QOL data were collected from a subset of TARGIT-A participants who received TARGIT-IORT as a separate procedure (postpathology)...
September 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Melinda Epstein, Melvin Silverstein, Kevin Lin, Brian Kim, Sadia Khan, Cristina De Leon, Lisa Guerra, Lincoln Snyder, Colleen Coleman, January Lopez, Ralph Mackintosh, Peter Chen
INTRODUCTION: Intraoperative radiation therapy (IORT) permits the delivery of radiation therapy directly to the tumor bed at the time of surgery. Minimal data are available about the complications associated with this modality of treatment using the Xoft(®) Axxent Electronic Brachytherapy (Axxent) System. METHODS: A total of 702 patients who received IORT using the Xoft(®) Axxent System at Hoag Memorial Hospital Presbyterian between June 2010-February 2016 were accrued in an IORT data registry study...
October 2016: Annals of Surgical Oncology
Emanuela Esposito, Rita Compagna, Massimo Rinaldo, Sara Falivene, Vincenzo Ravo, Bruno Amato, Paolo Muto, Massimiliano D'Aiuto
INTRODUCTION: Screening and adjuvant postoperative therapies have increased survival amongst women with breast cancer, but these tools are seldom applied in elderly patients. Higher rates of local recurrence occur in those elderly patients who avoid radiotherapy. TARGIT-A and ELIOT trials has been reported to not to be inferior to external beam RT in suitable subgroups of patients. The TARGIT-Elderly trial has been launched in order to confirm the efficacy of intraoperative radiotherapy (IORT) in a well selected group of elderly patients who are more likely to decline radiation treatment...
September 2016: International Journal of Surgery
Michela Massa, Simonetta Franchelli, Renzo Panizza, Tiberio Massa
After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy (IORT) instead of postoperative whole breast irradiation (WBI) after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for Radiation Oncology (ASTRO) and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) and monitoring the oncological outcome together with radiation toxicity on breast tissue...
April 2016: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Nathan J Coombs, Joel M Coombs, Uma J Vaidya, Julian Singer, Max Bulsara, Jeffrey S Tobias, Frederik Wenz, David J Joseph, Douglas A Brown, Richard Rainsbury, Tim Davidson, Douglas J A Adamson, Samuele Massarut, David Morgan, Ingrid Potyka, Tammy Corica, Mary Falzon, Norman Williams, Michael Baum, Jayant S Vaidya
OBJECTIVE: To quantify the journeys and CO2 emissions if women with breast cancer are treated with risk-adapted single-dose targeted intraoperative radiotherapy (TARGIT) rather than several weeks' course of external beam whole breast radiotherapy (EBRT) treatment. SETTING: (1) TARGIT-A randomised clinical trial (ISRCTN34086741) which compared TARGIT with traditional EBRT and found similar breast cancer control, particularly when TARGIT was given simultaneously with lumpectomy, (2) 2 additional UK centres offering TARGIT...
May 9, 2016: BMJ Open
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