Ms Siobhan Laws
Consultant Surgeon, Hampshire Hospitals NHS Foundation Trust
Targeted intraoperative radiation therapy presents a potential paradigm shift in breast cancer treatment delivered during surgery.
Radiation therapy is an important part of breast cancer treatment. Usually, patients will have surgery to remove their tumour — and only afterwards receive rounds of external beam radiotherapy (EBRT) to reduce the risk of the cancer returning. However, because EBRT is delivered to the entire breast in small doses every day for one to six weeks, patients must travel frequently for treatment.
Intraoperative radiation therapy for breast cancer
Women with early invasive breast cancer could potentially benefit from a ‘one-shot’ treatment — Targeted intraoperative radiation therapy (TARGIT-IORT). It’s delivered during surgery, and it’s more accurate. Trial data1 shows equivalence in breast relapse risk and better patient outcomes. It’s less painful, has better cosmetic effects, and patients can return to work one to two months faster.
“While under a general anaesthetic to remove the breast cancer, the space left behind is filled with a probe, and radiotherapy is delivered directly to the area in the breast most at risk of local relapse,” explains Ms Siobhan Laws, Consultant Surgeon at Hampshire Hospitals NHS Foundation Trust. Because TARGIT-IORT treatment is targeted, healthy tissues are protected from unnecessary exposure to potentially harmful radiation.
Deemed ‘an absolute no-brainer’ after learning about the trial, research2 patient member Marie Ennis O’Connor says: “As a breast cancer survivor … The incredible progress in treatments like TARGIT-IORT fills me with hope that future generations of women won’t have to endure the same gruelling radiotherapy experience I did.”
Because TARGIT-IORT treatment is targeted,
healthy tissues are protected from unnecessary
exposure to potentially harmful radiation.
Targeted treatment reduces healthcare pressures
TARGIT-IORT can benefit healthcare providers by ultimately freeing up physicists and radiation oncologists. Plus, it can be cost-effective. At least 44,752 patients with breast cancer were treated with TARGIT-IORT in 260 centres across 35 countries. It also saved over 20 million miles of travel and prevented approximately 2,000 non-breast cancer deaths.3
Use of the system is recommended only using machines that are already available and in conjunction with NHS England-specified clinical governance, data collection and submission arrangements.4 With new data, it is hoped that the National Institute for Health and Care Excellence (NICE) will approve TARGIT-IORT for routine NHS use. Nevertheless, Hampshire Hospitals NHS Foundation Trust has been offering the therapy to local NHS patients since 2019. “What is most exciting is the new long-term data1 showing an improvement in overall survival for those treated with TARGIT-IORT,” concludes Ms Laws.
[1] Vaidya J S, Bulsara M, Baum M, Wenz F, Massarut S, Pigorsch S et al. 2020.
[2] Bagga, S., Swiderska N., Hooker, C., Royle, J., O’Connor, M.E., Freeney, S., et. al. (2023). (The manuscript is going through the peer-review process at the moment and is not officially published.)
[3] Vaidya, J. S., Vaidya, U. J., Baum, M., Bulsara, M. K., Joseph, D., & Tobias, J. S. (2022).
[4] National Institute for Health and Care Excellence. (2018).
