Journal Article Ahead of print
PubMed: 40387868 DOI: 10.1007/s00066-025-02412-0
Oncological outcomes of breast cancer patients after planned IORT boost with low-kV x-rays-results of the TARGIT BQR prospective phase IV trial.
Strahlenther Onkol
Authors: Lukas Goerdt, Janina Pömsl, Uta Kraus-Tiefenbacher, Viktoria Brück, Christina Kaiser, Ralf Keymer, Yasser Abo-Madyan, Katharina Fleckenstein, Sebastian Berlit, Benjamin Tuschy, Marc Sütterlin, Frederik Wenz, Elena Sperk
Affiliations
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- Department of Pediatric and Adolescent Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany.
- Department of Radiation Oncology, Krankenhaus Nordwest, Frankfurt am Main, Germany.
- Asklepios Klinik Lich GmbH, Lich, Germany.
- University Medical Center Bonn, Medical Faculty Bonn, Bonn University, Bonn, Germany.
- Klinikum Kassel, Kassel, Germany.
- Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- Department of Gynecology and Obstetrics, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany.
- University Hospital Freiburg, Freiburg, Germany.
- Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- Mannheim Cancer Center, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, Mannheim, Germany.
Abstract
PURPOSE
The TARGIT BQR (boost quality registry) phase IV trial investigates clinical outcomes of breast cancer patients with standard external-beam radiotherapy (EBRT) of the whole breast and intraoperative radiotherapy (IORT) with low-kV x‑rays as an anticipated tumor bed boost in a real-world setting.
METHODS
Intraoperative radiotherapy was performed immediately after breast-conserving surgery in one fraction. External-beam radiotherapy and systemic treatment were given according to the German S3 guideline for breast cancer and local tumor board recommendations. Outcome parameters were death, local recurrence, metastasis, local lymph node recurrence, and ipsilateral and contralateral invasive breast cancer. Kaplan-Meier estimates were used to calculate overall survival, metastasis-free survival, local recurrence-free survival, and disease-free survival.
RESULTS
From 10 centers, 1133 patients were recruited. This analysis included 871 patients with 879 cancers, with a median follow-up of 36 months (up to 12 years). An IORT boost was performed in 82% and whole-breast irradiation in 84%. Overall survival was 98.4% after 3 years, 96.8% after 5 years, and 95.4% after 10 years (16 deaths; 1.8%). Metastasis and local recurrence occurred in 11 patients each (1.3%). At 5 years, the local control rate was 97.4% and local recurrence-free survival was 94.4%. Ipsilateral breast cancer occurred in 2 patients, contralateral breast cancer in 3 patients, and local lymph node recurrence in 2 patients. Disease-free survival was 92.9% after 5 years and 82.6% after 10 years.
CONCLUSION
This phase IV trial confirms previously reported outcomes on upfront IORT boost, with excellent disease-control outcomes.
MeSH
Radiotherapy, Lymph Nodes, Breast Neoplasms, Neoplasms, Neoplasm Metastasis, Lymph, Breast