Written by Ajanthy Arulpragasam Thursday, 29 July 2010 13:58
TARGETED intra-operative radiotherapy (TARGIT©) may one day become the standard treatment for post-surgery breast cancer radiotherapy according to the results of an international clinical trial involving WA researchers.
The outcomes of the randomised, controlled clinical trial which compared TARGIT© to the standard whole breast radiotherapy approach (external beam radiotherapy) found that TARGIT© could be used in favour of external beam radiotherapy.
The 10-year study, which was recently published in The Lancet involved over 2000 patients world-wide over the age of 45, including almost 300 patients who were recruited in WA at the QEII Medical Centre.
TARGIT© was found to have several advantages over external beam radiotherapy with the main advantage being that it was a more specific treatment to the actual site of where tumour had been excised from.
One of the study’s authors and the Head of the Radiation Oncology department at Sir Charles Gairdner Hospital, Professor David Joseph, says the TARGIT© approach is much less costly, has a lower risk of damage, has a better cosmetic result and means the patient can have local treatment delivered immediately.
“TARGIT© allows you to treat the patient in one day so from that point of view it’s very beneficial to the patient and also for radiation oncology departments generally because breast cancer occupies about a third of the total work load of radiation oncology departments and there’s a big deficiency of equipment and resources in Australia.
“So if you can treat a proportion of these patients with a single dose instead of six weeks of radiotherapy, not only would those patients get good treatment but you would free up the facilities for other patients who might need to have that treatment.
“The beauty of this device is that it can be used in a normal theatre with just a bit of shielding to protect the staff delivering the treatment.”
The TARGIT approach, originally developed to treat brain tumours, was adapted for breast cancer due to the pattern of failure for patients with mammography-detected low risk breast cancer.
“We were finding smaller and smaller better prognosis tumours because of mammographic screening and yet we were treating them all, as far as their local therapy is concerned, either by a mastectomy or by local surgery and radiotherapy for six weeks,” Professor Joseph says.
“A number of studies were done, first of all, to try to compare whole breast radiotherapy with no treatment, just hormone therapy for instance, and these failed so the patients tended to recur over a period of ten years with up to 30-40 pecent of cases.
“Most of these types of patients tended to occur just close to where the original surgery was so we were looking at a possible way of treating that part of the breast in the trail and that’s where we came up with TARGIT©.”
