Pioneering breast cancer therapy cuts time spent on hospital visits

Breast cancer patients could avoid repeated hospital visits, after a new study found that a single dose of radiotherapy during surgery is just as effective as a more conventional course of multiple doses.

The pioneering breast cancer therapy, developed by UCL clinicians, requires just one shot of radiotherapy rather than the conventional weeks-long treatment.

Targeted Intraoperative Radiotherapy – otherwise known as TARGIT-IORT – is administered immediately after a lumpectomy, using a small ball-shaped device placed inside the breast directly where the cancer was located.

According to researchers, the single-dose treatment, which lasts between  20 to 30 minutes, replaces the need for extra hospital visits, benefiting both patient safety and well-being.

The clinical trial, which was designed and run from UCL, began in 2000 and involved 2,298 women aged 45. The women, who all had breast cancer and a tumour of up to 3.5cm in size, were randomly assigned their treatment – with 1,140 patients given TARGIT-IORT and 1,158 given whole breast radiotherapy (EBRT).

Conventional external beam radiotherapy (EBRT) requires 15 to 30 hospital visits and typically involves a daily treatment session to the whole affected breast, over a period between three to six weeks.

More than 30 hospitals and medical centres in ten countries participated in the trial, including the UK, France, Germany, Italy, Norway, United States, Canada and Australia.

The findings showed that eight out of every ten patients treated with TARGIT-IORT therapy had no need for any further post-operative radiotherapy treatments.

The team also found that there was no detriment to survival rates and no increase in the likelihood of the cancer returning for women using TARGIT-IORT, while significantly fewer women died from causes other than breast cancer after having the treatment.

Professor Jayant Vaidya, lead author of the study and professor of Surgery and Oncology, UCL Surgery & Interventional Science, said: “With TARGIT-IORT, women can have their surgery and radiation treatment for breast cancer all at the same time.”

“This reduces the amount of time spent in hospital and enables women to recover more quickly, meaning they can get back to their lives more quickly.”

“With publication of these very positive long-term results, it is now clear that this treatment should be made much more freely available. It should be accessible to healthcare providers and discussed with patients when surgery for breast cancer is being planned.”

The TARGIT-IORT technique was developed by clinical academics, Professors Vaidya, Tobias and Baum, in 1998. Over the past 20 years, the technology has been throughout the world in over 260 medical health centres in 38 countries, helping to treat more than 45,000 patients.

Previous studies have shown that TARGIT-IORT has fewer radiation-related side effects compared with conventional whole breast radiotherapy, with less pain, better cosmetic outcome and a better quality of life.

Co-author of the study, Professor Jeffrey S Tobias, said: “With TARGIT-IORT, a large proportion of patients with breast cancer will never need to make the repeated daily visits to the radiotherapy centre. They avoid side effects of whole breast radiotherapy. Importantly, TARGIT-IORT reduces the burden on overstretched radiotherapy departments.”

Breast cancer remains one of the most common cancers within the UK and it is estimated that one in seven women will develop the illness in their lifetime.

According to Cancer Research UK, around 55,200 new invasive breast cancer cases are diagnosed each year, and around 23 per cent of all breast cancer cases in the UK are preventable.

In recent years, research has increasingly focused on finding the most effective breast cancer treatment.

In July of this year, for example, a 10 year trial found that treating breast cancer patients with radiotherapy delivered in fewer, but higher doses was just as effective as multiple small doses.

The trial, involving more than 900 patients and led by the Institute of Cancer Research, revealed that five larger radiotherapy doses after surgery once a week for five weeks caused similarly low rates of side effects in women with early-stage breast cancer as 25 daily doses over the same period.

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