TARGITing more than breast cancer
The University of Notre Dame Australia, Fremantle Campus
Internationally-acclaimed, targeted intra-operative radiotherapy (TARGIT), a world-first in breast cancer treatment, has significant psychological and financial benefits for patients in remote communities, says The University of Notre Dame Australia’s Professor of Biostatistics, Max Bulsara.
A technique designed to give ‘once-off’ radiotherapy to the tissues surrounding a cancer after surgical removal, TARGIT has been deemed equivalent to a conventional seven week course of external beam postoperative radiotherapy (EBRT).
A postgraduate studies supervisor at Notre Dame and previous winner of WA Inventor of the Year for Research, Professor Bulsara is a member of the TARGIT International Steering Committee and was the Trial Statistician responsible for the design, maintenance and analysis of data during the 10 year study.
“Since the very beginning of the trials, investigators truly believed in the potential of the TARGIT technique, which over the years was strengthened by research into its radiobiological effects and growing evidence on the patterns of recurrence within the affected breast,” said Professor Bulsara.
“Patients are showing a preference for TARGIT over EBRT for all sorts of reasons, even if that means putting themselves at higher risk of a local recurrence.
“They don’t want to subject their body to that extent of radiotherapy, knowing what the side effects might be, especially if they have a small, low-risk cancer.
“Also, patients who live remotely will often relocate for the seven week duration of their treatment, which adversely affects their work, creating financial burdens and a strain on domestic responsibilities.”
According to Professor Bulsara, TARGIT treatment gives patients more options whilst helping to reduce waiting lists for those requiring EBRT, who are not eligible for alternative forms of radiotherapy.
“Only those patients within close proximity to conventional treatment centres are likely to be offered radiotherapy as opposed to mastectomy. TARGIT would help those women in remote communities and the developed world who are outside these access areas,” he said.
“At this stage, some patients will choose to have a mastectomy instead of breast conserving surgery in order to avoid external beam radiotherapy. This course of action is likely to have quite a psychological impact.”
Professor Bulsara said the TARGIT device, originally designed to help treat intra-cranial tumours, is now being used by some clinicians in the United States for bowel cancer treatment. He said plans were also underway to extend the treatment to all breast cancer patients.
“The success of this device in treating early breast cancer will most certainly open the door for further trials in other cancers and other breast cancer risk groups,” he said.
“We want to extend this to all breast cancer patients undergoing breast conserving surgery. To achieve this, five additional randomised trials have to be conducted and we are currently in various stages of planning and implementing some of these trials.”
Professor Bulsara said he was moved by the number of patients expressing a willingness to join the trials in order to help women in the future, particularly if they had daughters or granddaughters.
“Patients feel they really are doing something to help and indeed they are,” he said.
Professor Bulsara and colleagues from 28 centres around the world, including West Australian Professors David Joseph of Sir Charles Gairdner Hospital and Christobel Saunders of UWA, attended the American Society of Clinical Oncology, Chicago, to present their findings in June. The TARGIT study has since received international attention, including publication in one of the world's best known, oldest, and most respected medical journals, The Lancet.
Andrea Barnard (+61) 8 9433 0610, Mob (+61) 0408 959 138
Barnard, Andrea, "TARGITing more than breast cancer" (2010). Media Release Archive. 120.