Environmental and social benefits of the targeted intraoperative radiotherapy for breast cancer: data from UK TARGIT-A trial centres and two UK NHS hospitals offering TARGIT IORT

Nathan J. Coombs, Joel M. Coombs, Uma J. Vaidya, Julian Singer, Max Bulsara, Jeffrey S. Tobias, Frederik Wenz, David Joseph, Douglas A. Brown, Richard Rainsbury, Tim Davidson, Douglas J. A. Adamson, Samuele Massarut, David Morgan, Ingrid Potyka, Tammy Corica, Mary Falzon, Norman Williams, Michael Baum, Jayant S. Vaidya

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Abstract

Objective

To quantify the journeys and CO2 emissionsif women with breast cancer are treated with risk-adapted single-dose targetedintraoperative radiotherapy (TARGIT) rather than several weeks' course ofexternal beam whole breast radiotherapy (EBRT) treatment.

Setting

(1) TARGIT-A randomised clinical trial (ISRCTN34086741)which compared TARGIT with traditional EBRT and found similar breast cancercontrol, particularly when TARGIT was given simultaneously with lumpectomy, (2)2 additional UK centres offering TARGIT.

Participants

485 UK patients (249 TARGIT, 236 EBRT) inthe prepathology stratum of TARGIT-A trial (where randomisation occurred beforelumpectomy and TARGIT was delivered simultaneously with lumpectomy) for whomgeographical data were available and 22 patients treated with TARGIT aftercompletion of the TARGIT-A trial in 2 additional UK breast centres.

Outcomemeasures

The shortest total journey distance, timeand CO2 emissions from home to hospital to receive all thefractions of radiotherapy.

Methods

Distances, time and CO2 emissionswere calculated using Google Maps and assuming a fuel efficiency of 40 mpg. Thegroups were compared using the Student t test with unequal variance and thenon-parametric Wilcoxon rank-sum (Mann-Whitney) test.

Results

TARGIT patients travelled significantlyfewer miles: TARGIT 21 681, mean 87.1 (SE 19.1) versus EBRT 92 591, mean 392.3(SE 30.2); had lower CO2 emissions 24.7 kg (SE 5.4) vs 111 kg (SE 8.6) and spentless time travelling: 3 h (SE 0.53) vs 14 h (SE 0.76), all p2 perpatient).

Conclusions

The use of TARGIT intraoperativeradiotherapy for eligible patients with breast cancer significantly reducestheir journeys for treatment and has environmental benefits. If widelyavailable, 5 million miles (8 000 000 km) of travel, 170 000 woman-hours and1200 tonnes of CO2 (a forest of 100 hectares) will be saved annually in theUK.

Trialregistration number

ISRCTN34086741; Post-results.

Original languageEnglish
Article number010703
Pages (from-to)1-10
Number of pages10
JournalBMJ Open
Volume6
Issue number5
DOIs
Publication statusPublished - 9 May 2016

Cite this

Coombs, N. J., Coombs, J. M., Vaidya, U. J., Singer, J., Bulsara, M., Tobias, J. S., Wenz, F., Joseph, D., Brown, D. A., Rainsbury, R., Davidson, T., Adamson, D. J. A., Massarut, S., Morgan, D., Potyka, I., Corica, T., Falzon, M., Williams, N., Baum, M., & Vaidya, J. S. (2016). Environmental and social benefits of the targeted intraoperative radiotherapy for breast cancer: data from UK TARGIT-A trial centres and two UK NHS hospitals offering TARGIT IORT. BMJ Open, 6(5), 1-10. [010703]. https://doi.org/10.1136/bmjopen-2015-010703