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Review
. 2022 Feb;17(1):81-84.
doi: 10.1159/000515386. Epub 2021 Apr 6.

Long-Term Results of the TARGIT-A Trial: More Questions than Answers

Marc D Piroth  1 , Vratislav Strnad  2 , David Krug  3 , Gerd Fastner  4 , René Baumann  5 , Stephanie E Combs  6 , Marciana Nona Duma  7 , Jürgen Dunst  3 , Petra Feyer  8 , Rainer Fietkau  2 , Wulf Haase  9 , Wolfgang Harms  10 , Thomas Hehr  11 , Felix Sedlmayer  4 , Rainer Souchon  12 , Wilfried Budach  13
Affiliations
Review

Long-Term Results of the TARGIT-A Trial: More Questions than Answers

Marc D Piroth et al. Breast Care (Basel). 2022 Feb.

Abstract

Background: During the last decade, partial breast irradiation (PBI) has gained traction as a relevant treatment option for patients with early-stage low-risk breast cancer after breast-conserving surgery. The TARGIT-A prospective randomized trial compared a "risk-adapted" intraoperative radiotherapy (IORT) approach with 50-kv X-rays (INTRABEAM®) as the PBI followed by optional whole-breast irradiation (WBI) and conventional adjuvant WBI in terms of observed 5-year in-breast recurrence rates. Recently, long-term data were published. Since the first publication of the TARGIT-A trial, a broad debate has been emerged regarding several uncertainties and limitations associated with data analysis and interpretation. Our main objective was to summarize the data, with an emphasis on the updated report and the resulting implications.

Summary: From our point of view, the previously unresolved questions still remain and more have been added, especially with regard to the study design, a change in the primary outcome measure, the significant number of patients lost to follow-up, and the lack of a subgroup analysis according to risk factors and treatment specifications.

Key message: Taking into account the abovementioned limitations of the recently published long-term results of the TARGIT-A trial, the German Society of Radiation Oncology (DEGRO) Breast Cancer Expert Panel adheres to its recently published recommendations on PBI: "the 50-kV system (INTRABEAM) cannot be recommended for routine adjuvant PBI treatment after breast-conserving surgery."

Keywords: Breast cancer; INTRABEAM technique; Intraoperative radiotherapy (IORT); Partial breast irradiation.

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Conflict of interest statement

V.S. declares consultation fees from Nucletron Operations BV, an Elekta Company, outside the submitted work. D.K. has received honoraria from Merck Sharp & Dome, outside of the submitted work. F.S. has received a study grant from Intraop Medical. G.F. has received a honorarium from Roche, outside of the submitted work. M.P., R.B., S.C., M.-N.D., J.D., P.F., R.F., Wu.H., Wo.H., T.H., R.S., and W.B. have no conflicts of interest to declare.

References

    1. Strnad V, Krug D, Sedlmayer F, Piroth MD, Budach W, Baumann R, et al. Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) DEGRO practical guideline for partial-breast irradiation. Strahlenther Onkol. 2020 Sep;196((9)):749–763. - PMC - PubMed
    1. Vaidya JS, Baum M, Tobias JS, D'Souza DP, Naidu SV, Morgan S, et al. Targeted intra-operative radiotherapy (Targit): an innovative method of treatment for early breast cancer. Ann Oncol. 2001 Aug;12((8)):1075–1080. - PubMed
    1. Vaidya JS, Baum M, Tobias JS, Morgan S, D'Souza D. The novel technique of delivering targeted intraoperative radiotherapy (Targit) for early breast cancer. Eur J Surg Oncol. 2002 Jun;28((4)):447–454. - PubMed
    1. Vaidya JS, Wenz F, Bulsara M, Tobias JS, Joseph DJ, Keshtgar M, et al. TARGIT trialists' group Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer: 5-year results for local control and overall survival from the TARGIT-A randomised trial. Lancet. 2014 Feb;383((9917)):603–613. - PubMed
    1. Silverstein MJ, Fastner G, Maluta S, Reitsamer R, Goer DA, Vicini F, et al. Intraoperative radiation therapy: a critical analysis of the ELIOT and TARGIT trials. Part 2—TARGIT. Ann Surg Oncol. 2014 Nov;21((12)):3793–3799. - PMC - PubMed