In the TARGIT-A trial comparing intraoperative radiotherapy (IORT) with targeted intrabeam device versus whole-breast external beam radiotherapy (WBRT) in early breast cancer, which finding is correct?
- A IORT showed significantly lower local recurrence at 5 years compared to WBRT
- B IORT was abandoned due to excess skin toxicity
- C IORT showed non-inferior local recurrence but significantly reduced non-breast cancer deaths ✓
- D IORT showed equivalence only in HER2+ tumors
Correct answer: C. IORT showed non-inferior local recurrence but significantly reduced non-breast cancer deaths
Explanation
The TARGIT-A trial showed that IORT with the Intrabeam device was associated with a higher 5-year local recurrence rate compared to WBRT (3.3% vs 1.3%), but crucially demonstrated significantly fewer non-breast cancer deaths (cardiovascular, other cancers) in the IORT group, resulting in similar overall survival. This reflects reduced collateral radiation damage to heart and lungs. IORT is currently acceptable for selected low-risk patients (ER+, node-negative, older women). Skin toxicity was actually lower with IORT.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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