Intraoperative radiotherapy for early breast cancer – Authors' reply
Vaidya, J. S., Joseph, D. J., Tobias, J. S., Bulsara, M. K., Wenz, F., Saunders, C., et al. (2010). Intraoperative radiotherapy for early breast cancer – Authors' reply. The Lancet, 376(9747), 1143-1144. doi:10.1016/S0140-6736(10)61533-4
We were delighted by the interest generated after the publication of the TARGIT-A trial results and are happy to provide clarifications and reassurance.
First, we wish to re-emphasise that the TARGIT-A trial compared “bespoke” radiotherapy—ie, the risk-adjusted approach of TARGIT (with added whole-breast external-beam radiotherapy depending on the individual risk) versus whole-breast external-beam radiotherapy for all. Overall, 14% of patients who received TARGIT also received external-beam radiotherapy. Of those who received TARGIT at the time of the first operation, 21% (141/669) received external-beam radiotherapy. Although nearly 80% of such patients did not have any further radiotherapy, we emphasise that this approach is implicit in the TARGIT-A protocol, which allowed addition of external-beam radiotherapy when indicated, rather than TARGIT as the only treatment in every patient. This pragmatic approach matches what clinicians should do in the real world.