Research reinforces Intraoperative Radiation Therapy's effectiveness in treatment of early stage breast cancer

Results from a decade-long international research trial, headed up by St John of God Subiaco Hospital breast surgeon Prof Christobel Saunders, confirm that use of single dose, targeted Intraoperative Radiation Therapy is as effective and efficient as traditional external beam radiotherapy.

14 Dec 2020

Caregivers in theatre during Intraoperative Radiation Therapy (IORT) treatment at St John of God Subiaco Hospital

Intraoperative Radiation Therapy is available for select women who have early stage breast cancer. It reduces treatment time from up to six or seven weeks of daily radiation to a single treatment that is administered while a patient is undergoing surgery to remove the tumour.

After a patient’s tumour is removed by a surgeon, and before the incision is closed, radiation is strategically delivered to the area where the tumour was located by a radiation oncologist. This provides a precise therapeutic dose to the location where recurrence is most likely to occur.

Radiation is applied for 20 to 30 minutes, targeting tissue in the tumour bed from the inside, while minimising healthy tissue exposure to radiation.

The study also reinforced the many patient benefits of Intraoperative Radiation Therapy, including convenience, reduced travel and personal costs, improved quality of life and fewer side effects.

St John of God Subiaco Hospital breast surgeon Prof Christobel Saunders AO is one of the trial’s primary investigators and leads the Australian division of the study, referred to as the 'Long term survival and local control outcomes from single dose targeted intraoperative radiotherapy during lumpectomy (TARGIT-IORT) for early breast cancer: TARGIT-A randomised clinical trial'.

Conducted by 32 centres across 10 countries, 2,298 individuals aged 45 years and older were recruited to participate in the trial between March 2000 and June 2012. 

All participants had an invasive ductal carcinoma up to 3.5cm in size and were eligible for breast conservation. Of the participants, 1,140 received  treatment and the remaining 1,158 received conventional radiotherapy.

On average, each participant was followed-up for 8.6 years as part of the trial.

Held over 20 years, the trial’s findings have shown that the local recurrence-free survival rate of women treated with single dose Intraoperative Radiation Therapy is non-inferior when compared to external beam radiotherapy.

In addition, the mortality in those receiving Intraoperative Radiation Therapy was lower in part because of fewer cardio-vascular deaths.

St John of God Subiaco Hospital became the first private hospital in Australia to introduce Intraoperative Radiation Therapy in April this year in collaboration with oncology provider, GenesisCare.

Since the treatment was introduced, more than 25 procedures have been conducted by St John of God Subiaco Hospital breast surgeons, Prof Christobel Saunders, Dr Lee Jackson, Dr Corinne Jones, A/Prof Ming Yew and Dr Wen Chan Yeow.

Prof Saunders said: "the results of this important study show that for some women with early stage and low risk breast cancer, Intraoperative Radiation Therapy can be an equally effective treatment option compared to traditional radiotherapy.”

“All St John of God Subiaco Hospital breast surgeons who perform Intraoperative Radiation Therapy are now contributing patient data to a register so that corresponding treatment guidelines can be established.” 

St John of God Subiaco Hospital has a strong focus on research and supporting clinical trials to provide patients the best clinical care and outcomes possible.

Of the 54 clinical trials conducted by St John of God Subiaco Hospital researchers and clinicians in the last financial year, 41 were specific to oncology.