Breast cancer The largest experience with IORT using the TARGIT technique and the best evidence for its potentials exists in breast cancer where a substantial number of patients have already been treated. Adoption At the St Gallen Breast Cancer Conference (16–19 March 2011) the consensus amongst over 52 breast cancer expert panelists was that TARGIT alone could be used as the only radiation treatment in selected cases after breast conserving surgery (49% yes, 36% no), or as a tumour bed boost instead of external beam<unk>  boost (62% yes, 23% no). On 25 July 2014 the UK National Institute for Health and Care Excellence (NICE) gave provisional recommendation for the use of TARGIT IORT with Intrabeam in the UK National Health Service. In September 2014, NICE requested further information from the clinical trial investigators, citing several comments and concerns. Concerns cited included the immaturity of the data with a median follow up of the entire population being only 2 years and 5 months as well as the noninferiority criterion used in the study. This extra information was supplied by the authors, and has since been published as part of the comprehensive paper on TARGIT-A trial. In 2017, NICE described it as an option for early breast cancer. The 2015 update of guidelines of the Association of Gynaecological Oncology (AGO) (an autonomous community of the German Society of Gynaecology and Obstetrics (DGGG) and the German Cancer Society) includes TARGIT IORT during lumpectomy as a recommended option for women with a T1, Grade 1 or 2, ER positive breast cancer. On 21 May 2015, the Australian Government Medical Services Advisory Committee (MSAC) announced that "After considering the available evidence in relation to safety, clinical effectiveness and cost-effectiveness, MSAC supported public funding of a new Medicare Benefits Schedule (MBS) item for treatment of pathologically documented invasive ductal breast cancer in eligible patients with TARGIT-IORT when used concurrently with breast-conserving surgery". The Australian Government also approved budget item for the treatment of early stage breast cancer using<unk>  and patients can avail of this treatment from 1 September 2015. On 26 May 2015, in response to a query by the British Medical Journal, NICE clarified that while their appraisal is going on, TARGIT IORT with Intrabeam can continue to be offered to patients who need it. About 260 centres in over 35 countries including North America (about 80 centres), South America, Europe (e.g., 60 centres in Germany), Australia, Middle East (e.g., 9 centres in Israel), and the Far East are currently using TARGIT IORT for breast cancer treatment, and over 45,000 patients have so far been treated using TARGIT IORT. Several independent studies from USA, South America, Denmark, Germany, France, Switzerland, Russia, South Korea, Singapore, South Africa, and China have found excellent results with the use of TARGIT IORT. Evaluation of the long-term outcomes in patients who were treated with TARGIT-IORT for breast cancer confirmed that it is as effective as whole breast external beam<unk>  in controlling cancer, and also reduces deaths from other causes as shown in a large international randomised clinical trial published in the British Medical Journal. According to a recent report, while deaths from breast cancer with more focussed radiation (TARGIT-IORT) were similar to whole breast radiation, deaths from other causes such as cardiovascular or lung problems or from other cancers were found to be substantially reduced from 9.85% to 5.41% over a 12-year follow up. Compared with whole breast radiation, the risk-adapted TARGIT-IORT approach needs fewer hospital visits and has lower toxicity. Other benefits include reduced breast pain, a better quality of life and a cosmetically superior outcome. The TARGIT-A trial included a large number of higher-risk patients: 1898 (83%) were younger than 70 years, 366 (16%) had tumours >2 cm in size, 443 (20%) patients had grade 3 cancers, 488 (22%) patients had involved nodes, and 426 (19%) had ER- or PgR-negative tumours. Therefore, the TARGIT-IORT approach is suitable for patients with much wider selection criteria compared with other partial breast radiation techniques The eligibility criteria are age >=45 years with breast cancer (invasive ductal carcinoma) suitable for breast preservation, with tumour size less than 3.5 cm in size.
Targeted intra-operative radiotherapy
Intraoperative electron radiation therapy
Intraoperative radiation therapy
Selective internal radiation therapy
Image-guided radiation therapy
Radical surgery
Blood irradiation therapy
Diffusing alpha emitters radiation therapy