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CompletedNCT01440010TARGIT_BQRUpdated Dec 12, 2025Results posted

TARGeted Intraoperative radioTherapy With INTRABEAM as a Boost for Breast Cancer - A Quality Control Registry

An observational study in Breast Cancer, sponsored by Universitätsmedizin Mannheim. Completed at 1 site in Germany. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-12-12.

Sponsored by Universitätsmedizin Mannheim · Observational

Study type
Observational
Model
Ecologic or community
Time perspective
Prospective
Enrollment
1,133
Ages
18 Years and older
Sex
Female
01

Study summary

Quality Control Registry for IORT used as an anticipiated boost with 20 Gy at the applicator surface followed by EBRT

Read the detailed description

Quality Control Registry of a standard treatment with intraoperative radiotherapy during breast conserving surgery with 20 Gy at the applicator surface as an advanced boost followed by a shortened external beam radiotherapy. This is a prospective phase IV study to evaluate real life data of IORT Boost. Study runs in Germany with 13 active centers recruiting. Due to the nature of the study (registry) there is no need for randomization. Inclusion of n = >1000 patients is planned.

02

Conditions studied

  • Breast Cancer

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Keywords

  • IORT
  • Boost
  • Breast cancer
  • Local recurrence
  • Toxicity
  • LENT SOMA
  • TARGIT
  • Quality Control Registry
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

All patients with breast cancer and a tumor diameter \< 3,5 cm plannend for breast conserving surgery. Intraoperative radiotherapy (IORT) is applied as an advanced boost with 20 Gy at the applicator surface during surgery. Its feasibility was already shown. IORT as a boost is considered as one of several boost techniques in the S3-Leitlinie (national guideline) for breast cancer.

Inclusion criteria

  • Tumor diameter \< 3,5 cm
  • Informed consent

Exclusion criteria

Exclusion Criteria:

  • No informed consent
  • Tumor size > 3,5 cm
  • No indication for a boost
04

Study design

Observational model
Ecologic or community
Time perspective
Prospective
Enrollment
1,133 participants (actual)

Groups and cohorts

  • IORT with 50 kV x-rays, 20 Gy

    Boost with 20 Gy during BCS, EBRT with 46-50 Gy

    Radiation: IORT with 20 Gy

Interventions

  • RadiationIORT with 20 Gy

    Intraoperative radiotherapy with the INTRABEAM System with 20 Gy

    Also known as: Whole breast irradiation

05

What researchers measure

Primary outcomes

  1. Number of Patients With Local Recurrence

    The follow-up was carried out every six months for the first two years, and then once a year. The follow-up always included a mammography in addition to a clinical examination. Kaplan-Meier-estimates were done to calculate the local recurrence rate

    Time frame: 5 years

Secondary outcomes

  1. Percentage of Patients With Chronic Higher Grade Fibrosis After IORT Boost

    Follow-up for toxicity assessment (LENT SOMA criteria: fibrosis, teleangiectasia, retraction, pain, breast edema, lymphedema, hyperpigmentation, ulceration) and oncological data took place before surgery, 6 weeks to 90 days after EBRT, 6 months after IORT, and then annually using standardized case report forms (CRFs).

    Time frame: 84 months

06

Results

Posted Dec 12, 2025
Limitations and caveats
902 patients were available for any analysis. Be aware that 8 patients with both sided cancers were included. So there were 910 affected breasts in 902 patients.

Participant flow

Participant flow — Overall Study
MilestoneIORT With 50 kV X-rays, 20 Gy
Started1133
Completed902
Not completed231

Outcome measures

PrimaryNumber of Patients With Local Recurrence

The follow-up was carried out every six months for the first two years, and then once a year. The follow-up always included a mammography in addition to a clinical examination. Kaplan-Meier-estimates were done to calculate the local recurrence rate

Time frame:
5 years
Reported as:
Number · participants
Number of Patients With Local Recurrence
participantsIORT Boost
Number of Patients With Local Recurrence10
SecondaryPercentage of Patients With Chronic Higher Grade Fibrosis After IORT Boost

Follow-up for toxicity assessment (LENT SOMA criteria: fibrosis, teleangiectasia, retraction, pain, breast edema, lymphedema, hyperpigmentation, ulceration) and oncological data took place before surgery, 6 weeks to 90 days after EBRT, 6 months after IORT, and then annually using standardized case report forms (CRFs).

Time frame:
84 months
Reported as:
Count of participants · Participants
Percentage of Patients With Chronic Higher Grade Fibrosis After IORT Boost
ParticipantsIORT Boost
Percentage of Patients With Chronic Higher Grade Fibrosis After IORT Boost132

Adverse events

Collected over 5 years. Non-serious events are listed at a 4% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
IORT Boost With 20 Gy and Standard Whole Breast Irradition16/902 (1.8%)0/902 (0%)83/902 (9.2%)
Most frequent other events
Most frequent other events
EventIORT Boost With 20 Gy and Standard Whole Breast Irradition
Palpable seromaSkin and subcutaneous tissue disorders83/902
ErythemaSkin and subcutaneous tissue disorders40/902

Baseline characteristics

902 with complete paper work and minimum follow-up data set

Age, Continuous
Age, Continuous(years)IORT Boost With 20 Gy and Standard Whole Breast Irradition
Median61 (30 to 90)
Sex: Female, Male
Sex: Female, Male(Participants)IORT Boost With 20 Gy and Standard Whole Breast Irradition
Female902
Male0
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)IORT Boost With 20 Gy and Standard Whole Breast Irradition
07

Study locations

1 site
  • University Medical Center Mannheim
    Mannheim, 68167, Germany
08

References and documents

Publications

  • Andersen KG, Gartner R, Kroman N, Flyger H, Kehlet H. Persistent pain after targeted intraoperative radiotherapy (TARGIT) or external breast radiotherapy for breast cancer: a randomized trial. Breast. 2012 Feb;21(1):46-9. doi: 10.1016/j.breast.2011.07.011. Epub 2011 Aug 23. PubMed 21865044 ↗
  • Sautter-Bihl ML, Sedlmayer F, Budach W, Dunst J, Engenhart-Cabillic R, Fietkau R, Feyer P, Haase W, Harms W, Rodel C, Souchon R, Wenz F, Sauer R. Intraoperative radiotherapy as accelerated partial breast irradiation for early breast cancer : beware of one-stop shops? Strahlenther Onkol. 2010 Dec;186(12):651-7. doi: 10.1007/s00066-010-8001-2. PubMed 21127826 ↗
  • Vaidya JS, Baum M, Tobias JS, Wenz F, Massarut S, Keshtgar M, Hilaris B, Saunders C, Williams NR, Brew-Graves C, Corica T, Roncadin M, Kraus-Tiefenbacher U, Sutterlin M, Bulsara M, Joseph D. Long-term results of targeted intraoperative radiotherapy (Targit) boost during breast-conserving surgery. Int J Radiat Oncol Biol Phys. 2011 Nov 15;81(4):1091-7. doi: 10.1016/j.ijrobp.2010.07.1996. Epub 2010 Oct 15. PubMed 20951505 ↗
  • Keshtgar MR, Vaidya JS, Tobias JS, Wenz F, Joseph D, Stacey C, Metaxas MG, Keller A, Corica T, Williams NR, Baum M. Targeted intraoperative radiotherapy for breast cancer in patients in whom external beam radiation is not possible. Int J Radiat Oncol Biol Phys. 2011 May 1;80(1):31-8. doi: 10.1016/j.ijrobp.2010.01.045. Epub 2010 Jun 18. PubMed 20646864 ↗
  • Vaidya JS, Joseph DJ, Tobias JS, Bulsara M, Wenz F, Saunders C, Alvarado M, Flyger HL, Massarut S, Eiermann W, Keshtgar M, Dewar J, Kraus-Tiefenbacher U, Sutterlin M, Esserman L, Holtveg HM, Roncadin M, Pigorsch S, Metaxas M, Falzon M, Matthews A, Corica T, Williams NR, Baum M. Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial. Lancet. 2010 Jul 10;376(9735):91-102. doi: 10.1016/S0140-6736(10)60837-9. PubMed 20570343 ↗
  • Herskind C, Griebel J, Kraus-Tiefenbacher U, Wenz F. Sphere of equivalence--a novel target volume concept for intraoperative radiotherapy using low-energy X rays. Int J Radiat Oncol Biol Phys. 2008 Dec 1;72(5):1575-81. doi: 10.1016/j.ijrobp.2008.08.009. PubMed 19028280 ↗
  • Belletti B, Vaidya JS, D'Andrea S, Entschladen F, Roncadin M, Lovat F, Berton S, Perin T, Candiani E, Reccanello S, Veronesi A, Canzonieri V, Trovo MG, Zaenker KS, Colombatti A, Baldassarre G, Massarut S. Targeted intraoperative radiotherapy impairs the stimulation of breast cancer cell proliferation and invasion caused by surgical wounding. Clin Cancer Res. 2008 Mar 1;14(5):1325-32. doi: 10.1158/1078-0432.CCR-07-4453. PubMed 18316551 ↗
  • Welzel G, Hofmann F, Blank E, Kraus-Tiefenbacher U, Hermann B, Sutterlin M, Wenz F. Health-related quality of life after breast-conserving surgery and intraoperative radiotherapy for breast cancer using low-kilovoltage X-rays. Ann Surg Oncol. 2010 Oct;17 Suppl 3:359-67. doi: 10.1245/s10434-010-1257-z. Epub 2010 Sep 19. PubMed 20853059 ↗
  • Kraus-Tiefenbacher U, Blank E, Wenz F. Intraoperative radiotherapy during a second breast-conserving procedure for relapsed breast cancer after previous external beam radiotherapy. Int J Radiat Oncol Biol Phys. 2011 Jul 15;80(4):1279-80. doi: 10.1016/j.ijrobp.2011.02.038. No abstract available. PubMed 21683889 ↗
  • Wasser K, Ruch M, Brade J, Schoeber C, Kraus-Tiefenbacher U, Schnitzer A, Engel D, Wenz F, Sutterlin M, Schoenberg SO, Buesing KA. Do structural changes in the tumour bed after intraoperative radiotherapy (IORT) of breast cancer complicate the evaluation of mammograms in a long-term follow-up? Eur J Radiol. 2012 Mar;81(3):e255-9. doi: 10.1016/j.ejrad.2011.02.016. Epub 2011 Mar 4. PubMed 21376493 ↗
  • Blank E, Kraus-Tiefenbacher U, Welzel G, Keller A, Bohrer M, Sutterlin M, Wenz F. Single-center long-term follow-up after intraoperative radiotherapy as a boost during breast-conserving surgery using low-kilovoltage x-rays. Ann Surg Oncol. 2010 Oct;17 Suppl 3:352-8. doi: 10.1245/s10434-010-1265-z. Epub 2010 Sep 19. PubMed 20853058 ↗
  • Herskind C, Wenz F. Radiobiological comparison of hypofractionated accelerated partial-breast irradiation (APBI) and single-dose intraoperative radiotherapy (IORT) with 50-kV X-rays. Strahlenther Onkol. 2010 Aug;186(8):444-51. doi: 10.1007/s00066-010-2147-9. Epub 2010 Jul 29. PubMed 20803285 ↗
  • Wenz F, Welzel G, Blank E, Hermann B, Steil V, Sutterlin M, Kraus-Tiefenbacher U. Intraoperative radiotherapy as a boost during breast-conserving surgery using low-kilovoltage X-rays: the first 5 years of experience with a novel approach. Int J Radiat Oncol Biol Phys. 2010 Aug 1;77(5):1309-14. doi: 10.1016/j.ijrobp.2009.06.085. Epub 2010 Jan 25. PubMed 20100643 ↗
  • Ruch M, Brade J, Schoeber C, Kraus-Tiefenbacher U, Schnitzer A, Engel D, Wenz F, Sutterlin M, Schoenberg SO, Wasser K. Long-term follow-up-findings in mammography and ultrasound after intraoperative radiotherapy (IORT) for breast cancer. Breast. 2009 Oct;18(5):327-34. doi: 10.1016/j.breast.2009.09.010. PubMed 19909898 ↗
  • Kraus-Tiefenbacher U, Welzel G, Brade J, Hermann B, Siebenlist K, Wasser KS, Schneider FS, Sutterlin M, Wenz F. Postoperative seroma formation after intraoperative radiotherapy using low-kilovoltage X-rays given during breast-conserving surgery. Int J Radiat Oncol Biol Phys. 2010 Jul 15;77(4):1140-5. doi: 10.1016/j.ijrobp.2009.06.008. Epub 2009 Oct 14. PubMed 19836152 ↗
  • Wenz F, Budach W, Dunst J, Feyer P, Haase W, Harms W, Sautter-Bihl ML, Sedlmayer F, Souchon R, Sauer R; DEGRO Expert Panel Breast Cancer. Accelerated partial-breast irradiation (APBI)--ready for prime time? Strahlenther Onkol. 2009 Oct;185(10):653-5. doi: 10.1007/s00066-009-8002-1. No abstract available. PubMed 19806329 ↗
  • Wenz F, Welzel G, Keller A, Blank E, Vorodi F, Herskind C, Tome O, Sutterlin M, Kraus-Tiefenbacher U. Early initiation of external beam radiotherapy (EBRT) may increase the risk of long-term toxicity in patients undergoing intraoperative radiotherapy (IORT) as a boost for breast cancer. Breast. 2008 Dec;17(6):617-22. doi: 10.1016/j.breast.2008.05.009. Epub 2008 Jul 22. PubMed 18650091 ↗
  • Kraus-Tiefenbacher U, Bauer L, Scheda A, Schoeber C, Schaefer J, Steil V, Wenz F. Intraoperative radiotherapy (IORT) is an option for patients with localized breast recurrences after previous external-beam radiotherapy. BMC Cancer. 2007 Sep 14;7:178. doi: 10.1186/1471-2407-7-178. PubMed 17854511 ↗
  • Wasser K, Schoeber C, Kraus-Tiefenbacher U, Bauer L, Brade J, Teubner J, Wenz F, Neff W. Early mammographic and sonographic findings after intraoperative radiotherapy (IORT) as a boost in patients with breast cancer. Eur Radiol. 2007 Jul;17(7):1865-74. doi: 10.1007/s00330-006-0556-z. Epub 2007 Jan 20. PubMed 17237946 ↗
  • Vaidya JS, Baum M, Tobias JS, Massarut S, Wenz F, Murphy O, Hilaris B, Houghton J, Saunders C, Corica T, Roncadin M, Kraus-Tiefenbacher U, Melchaert F, Keshtgar M, Sainsbury R, Douek M, Harrison E, Thompson A, Joseph D. Targeted intraoperative radiotherapy (TARGIT) yields very low recurrence rates when given as a boost. Int J Radiat Oncol Biol Phys. 2006 Dec 1;66(5):1335-8. doi: 10.1016/j.ijrobp.2006.07.1378. Epub 2006 Nov 2. PubMed 17084562 ↗
  • Kraus-Tiefenbacher U, Bauer L, Scheda A, Fleckenstein K, Keller A, Herskind C, Steil V, Melchert F, Wenz F. Long-term toxicity of an intraoperative radiotherapy boost using low energy X-rays during breast-conserving surgery. Int J Radiat Oncol Biol Phys. 2006 Oct 1;66(2):377-81. doi: 10.1016/j.ijrobp.2006.05.042. Epub 2006 Aug 2. PubMed 16887294 ↗
  • Kraus-Tiefenbacher U, Bauer L, Kehrer T, Hermann B, Melchert F, Wenz F. Intraoperative radiotherapy (IORT) as a boost in patients with early-stage breast cancer -- acute toxicity. Onkologie. 2006 Mar;29(3):77-82. doi: 10.1159/000091160. Epub 2006 Mar 3. PubMed 16514267 ↗
  • Kraus-Tiefenbacher U, Scheda A, Steil V, Hermann B, Kehrer T, Bauer L, Melchert F, Wenz F. Intraoperative radiotherapy (IORT) for breast cancer using the Intrabeam system. Tumori. 2005 Jul-Aug;91(4):339-45. doi: 10.1177/030089160509100411. PubMed 16277101 ↗
  • Pez M, Keller A, Welzel G, Abo-Madyan Y, Ehmann M, Tuschy B, Berlit S, Sutterlin M, Wenz F, Giordano FA, Sperk E. Long-term outcome after intraoperative radiotherapy as a boost in breast cancer. Strahlenther Onkol. 2020 Apr;196(4):349-355. doi: 10.1007/s00066-019-01525-7. Epub 2019 Oct 22. PubMed 31641788 ↗
  • Goerdt L, Poemsl J, Spaich S, Welzel G, Abo-Madyan Y, Ehmann M, Berlit S, Tuschy B, Sutterlin M, Wenz F, Sperk E. Longitudinal cosmetic outcome after planned IORT boost with low kV X-rays-monocentric results from the TARGIT BQR registry. Transl Cancer Res. 2023 Jul 31;12(7):1715-1726. doi: 10.21037/tcr-23-88. Epub 2023 Jun 27. PubMed 37588731 ↗

Study documents

  • Study protocol · Jul 31, 2011
  • Statistical analysis plan · Dec 9, 2025

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT01440010
Lead sponsor
Universitätsmedizin Mannheim
Responsible party
Elena Sperk, MD (Senior Consultant, Managing Director Clinical Trials Unit Mannheim Cancer Center, Universitätsmedizin Mannheim) — Principal investigator
First posted
Sep 23, 2011
Start date
Sep 1, 2011
Primary completion
Dec 31, 2020
Completion
Dec 31, 2020
Results posted
Dec 12, 2025
Last update
Dec 12, 2025

Study contacts

Elena Sperk, MD
principal investigator · Universitätsmedizin Mannheim

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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