One-dose radiation therapy found effective for breast cancer patients

Targeted intra-operative radiotherapy is an effective alternative to external beam radiation therapy (EBRT) in the treatment of some women with breast cancer, a new study published this month by the British Medical Association’s BMJ medical journal.

Targeted intra-operative radiotherapy, referred to as TARGIT-IORT, is an intensive radiation treatment that’s administered one time during surgery, explained Dr. Merav Ben-David, head of the radiation-oncology department at Assuta Medical Center, a private medical center in the Ramat HaHayal neighborhood of northern Tel Aviv. The treatment allows direct radiation to reach the target area while sparing normal surrounding tissue.

In comparison, EBRT delivers tightly targeted radiation beams from outside the body for several sessions after surgery is complete.

Ben-David said that of the more than 4,500 Israeli women who are diagnosed with breast cancer each year in the country, as many as 99% require radiation therapy.

IORT spares women having to go to the hospital 15 times, improves their quality of life and has been found to benefit the economy, Ben-David said. However, until now, there was some question as to whether it was as effective as the standard protocol.

This new study – a multi-center investigation conducted in Europe, the United States and Australia – is the largest and longest term study on the subject to date.

The study found that TARGIT-IORT was not inferior to EBRT. The local recurrence risk at five years with complete follow-up was 2.11% for TARGIT-IORT compared with 0.95% for EBRT. However, although in the first five years 13 additional local recurrences were reported, there were 14 fewer deaths for TARGIT-IORT compared with EBRT.

With long-term follow up (an average of about nine years), no statistically significant difference was found for local recurrence-free survival.

In other words, for women who meet the criteria, immediate, single-dose TARGIT-IORT lumpectomy is an effective alternative to EBRT.

Ben-David said that the study – being published in October, which is Breast Cancer Awareness Month – is meant to highlight the treatment as an alternative for women, including in Israel.

IORT is available at many centers throughout Israel, including Assuta and all Clalit hospitals. She said that around 25% of all breast cancer patients are eligible. Patients should be over the age of 50 and have non-aggressive ductal carcinoma. The tumor should be small – about three centimeters – and the lymph nodes in the armpit should be negative for cancer.

“Women should consult with their surgeon and radiation oncologist to see if they are eligible,” Ben-David recommended.