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Background <p>Targeted intraoperative radiation therapy (TARGIT-IORT) is a promising alternative to standard external radiation for the treatment of early-stage breast cancer. However, American Society for Radiation Oncology guidelines have limited its use. We aimed to present our long-term results with the use of TARGIT-IORT in a very restricted population.</p> Methods <p>The electronic records of a tertiary medical center were retrospectively searched for women diagnosed with invasive ductal carcinoma from 2014 to 2023. Inclusion criteria were age &gt;&#xa0;50 years, unifocal disease, tumor size &lt;&#xa0;3 cm, and clinical subtype estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-non-amplified. Those with a favorable pathology after completion of lumpectomy and sentinel lymph node biopsy (SLNB) underwent TARGIT-IORT consisting of delivery of a single high dose of radiation (20 Gy) to an applicator inserted into the tumor bed using low-energy X-rays (50 Kv) over 22–29 minutes. Follow-up consisted of clinical examination every 6 months in the first 2 years and then mammography and breast ultrasound annually.</p> Results <p>The cohort included 219 patients with a median age of 66 years (range 50–83). During a median follow-up of 85 months, there was one case each (0.45%) of ipsilateral breast tumor recurrence, axillary lymph node recurrence, and isolated liver metastasis. In total, 20 patients (9.1%) had minor wound complications, and three (1.4%) had fat necrosis, self-limiting in all cases, with no need for hospital readmission.</p> Conclusion <p>TARGIT-IORT is associated with excellent local control, very high survival rates, and a very low toxicity profile for low-risk early breast cancer, consistent with the TARGIT-A trial and should be offered to patients when suitable.</p>

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Intraoperative Radiotherapy for Breast Cancer: Long-Term Experience

  • 期刊论文

  • 发表日期：

    2026年6月29日

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  • Shlomit Fennig,
  • Anna Kirshtein,
  • Yosef Landman,
  • Noam Weiner,
  • Eyal Fenig,
  • Eran Sharon

摘要

Background

Targeted intraoperative radiation therapy (TARGIT-IORT) is a promising alternative to standard external radiation for the treatment of early-stage breast cancer. However, American Society for Radiation Oncology guidelines have limited its use. We aimed to present our long-term results with the use of TARGIT-IORT in a very restricted population.

Methods

The electronic records of a tertiary medical center were retrospectively searched for women diagnosed with invasive ductal carcinoma from 2014 to 2023. Inclusion criteria were age > 50 years, unifocal disease, tumor size < 3 cm, and clinical subtype estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-non-amplified. Those with a favorable pathology after completion of lumpectomy and sentinel lymph node biopsy (SLNB) underwent TARGIT-IORT consisting of delivery of a single high dose of radiation (20 Gy) to an applicator inserted into the tumor bed using low-energy X-rays (50 Kv) over 22–29 minutes. Follow-up consisted of clinical examination every 6 months in the first 2 years and then mammography and breast ultrasound annually.

Results

The cohort included 219 patients with a median age of 66 years (range 50–83). During a median follow-up of 85 months, there was one case each (0.45%) of ipsilateral breast tumor recurrence, axillary lymph node recurrence, and isolated liver metastasis. In total, 20 patients (9.1%) had minor wound complications, and three (1.4%) had fat necrosis, self-limiting in all cases, with no need for hospital readmission.

Conclusion

TARGIT-IORT is associated with excellent local control, very high survival rates, and a very low toxicity profile for low-risk early breast cancer, consistent with the TARGIT-A trial and should be offered to patients when suitable.