Targeted intra-operative radiotherapy

Targeted Intra-operative Radiotherapy (TARGIT) is a form of radiation therapy used primarily in the treatment of breast cancer. This technique allows for the delivery of radiation directly to the tumor site during surgery, immediately after the tumor is removed. This approach aims to minimize the exposure of healthy tissue to radiation and reduce the side effects associated with traditional radiotherapy.

Overview

TARGIT is typically performed during a lumpectomy, a surgical procedure to remove a breast tumor and a small margin of surrounding tissue. Once the tumor is excised, a specialized device is used to deliver a single, high dose of radiation directly to the tumor bed, targeting areas where cancer is most likely to recur. This method contrasts with conventional radiotherapy, which often requires multiple sessions over several weeks, targeting the whole breast or a large part of it.

Advantages

The primary advantage of TARGIT is its ability to concentrate radiation exactly where it is needed, reducing the risk of damaging healthy tissue and organs nearby, such as the heart and lungs. This targeted approach can lead to fewer side effects, such as skin irritation and fatigue, compared to traditional radiotherapy. Additionally, because the radiation is delivered during surgery, patients can avoid the inconvenience and stress of returning for daily radiation treatments over several weeks.

Indications

TARGIT is most commonly used in patients with early-stage breast cancer who are undergoing a lumpectomy. It is particularly beneficial for patients who live far from treatment centers or have difficulty completing a full course of external beam radiotherapy due to personal or medical reasons.

Procedure

The procedure involves the use of a miniaturized radiation device that is inserted into the lumpectomy cavity immediately after the tumor is removed. The device emits radiation for a few minutes, targeting the area around the cavity where cancer cells are most likely to remain. After the radiation dose is delivered, the device is removed, and the surgical incision is closed.

Efficacy

Several studies have compared TARGIT to traditional external beam radiotherapy, with many showing similar rates of cancer recurrence and survival. However, the suitability of TARGIT for all breast cancer patients is still under investigation, and it is generally considered an option for those with a low risk of recurrence.

Risks and Complications

While TARGIT reduces the exposure of healthy tissues to radiation, it is not without risks. Potential complications include infection, bleeding, and delayed wound healing at the surgery site. There is also a small risk of radiation-induced damage to nearby tissues or organs, although this is less common than with external beam radiotherapy.

Conclusion

Targeted Intra-operative Radiotherapy represents a significant advancement in the treatment of breast cancer, offering a more convenient and potentially less toxic alternative to traditional radiotherapy. As research continues, the indications for TARGIT may expand, benefiting a broader range of patients.