title: The TARGIT trial: targeted intraoperative radiation therapy versus conventional postoperative whole-breast radiotherapy after breast-conserving surgery for the management of early-stage invasive breast cancer (a trial update).
abstract: BACKGROUND
  The principal objective of the targeted intraoperative radiation therapy trial was to determine whether single-fraction intraoperative radiotherapy (IORT) targeted to the tumor bed provides equivalent local control compared with whole-breast irradiation in patients with early-stage invasive breast cancer.
  
  
  METHODS
  Patients were randomized equally to IORT versus whole breast irradiation. Patients randomized to IORT received tumor bed irradiation prescribed at 20 Gy to the surgical margins using soft x-rays (50 kV) delivered with the Intrabeam Photon Radiosurgery System (Zeiss Inc, Oberkochen, Germany). Patients randomized to whole-breast irradiation received radiotherapy postoperatively. Prior wide local excision was allowed. Patients randomized to IORT after initial breast-conserving surgery received IORT at a second operation.
  
  
  RESULTS
  A total of 779 patients were accrued at 16 institutions internationally. Five hundred sixty patients were randomized before initial breast-conserving surgery. One hundred eighty-three patients were randomized after initial breast-conserving surgery. The median follow-up time was 359 days.
  
  
  CONCLUSIONS
  Targeted IORT allowed the entire dose of radiotherapy to be administered in a single fraction at the time of breast-conserving surgery, thus avoiding the need for repeated radiotherapy treatments or placement of indwelling radiotherapy devices.
authors.affiliation: American College of Surgeon, 55 East Erie Street, Chicago, IL 60611-2797, USA. dholmes@usc.edu
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Holmes
authors.forename: Michael
authors.initials: M
authors.lastname: Baum
authors.forename: David
authors.initials: D
authors.lastname: Joseph
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D004867:Equipment Design; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008408:Mastectomy / Q000379:methods*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011182:Postoperative Care; D016634:Radiosurgery / Q000295:instrumentation