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Radiotherapy during breast cancer surgery cuts cost and time

One targeted intraoperative dose saves women’s travel time and costs, cutting CO2 emissions

Louise Prime

Tuesday, 10 May 2016

Giving patients undergoing surgery for early-stage breast cancer a single, targeted intraoperative dose of radiotherapy saves women hundreds of miles and many hours of travel, costs and fuel and has the potential to cut the UK’s carbon dioxide (CO2) emissions by well over a thousand tonnes a year, according to research* published today in BMJ Open. Authors of the study have called for this approach – known as TARGIT – to become a routine treatment option for NHS patients, as it already is in many other countries.

TARGIT is not routinely available in the UK’s 62 hospitals with radiotherapy units, although previous international research (the TARGIT-A trial) has shown that for early-stage breast cancer in suitable patients it is as good as the UK’s standard treatment, standard external beam radiotherapy (EBRT). Although TARGIT lengthens surgery time by 20-40 minutes, patients then don’t usually need to return for daily hospital visits to complete a standard course of radiotherapy.

An international team of researchers led from the UK compared the travel implications, journey times and environmental impact of TARGIT and EBRT in 485 women who had taken part in TARGIT-A (roughly half of whom had each therapy), as well as an additional 22 women treated with TARGIT at two other semi-rural centres after TARGIT-A had ended.

They calculated that, on average, TARGIT patients travelled significantly fewer miles than EBRT patients (mean 87.1 miles vs 392.3 miles); had lower CO2 emissions (24.7kg vs 111kg, based on a standard family car) and spent less time travelling (3 hours vs 14 hours). Savings were even greater for those women treated with TARGIT at the two semirural hospitals – 753 miles shorter journeys and 30 hours’ less travelling time than EBRT, on average, saving 215kg CO2 per patient.

Based on there being about 50,000 breast cancer diagnoses every year in the UK, the researchers worked out that making TARGIT widely available across the NHS could save a total of 5 million miles, 170,000 hours’ travel time and 1,200 tonnes of CO2 emissions annually. They pointed out that this would be considerably ‘greener’ than the estimated savings from introducing a different mode of improving access to services (mobile breast screening units), which is about 1.25kg CO2 per woman screened.

They concluded: “Introducing TARGIT as an option for appropriate patients in the UK will contribute significantly to saving patients time, cost, fuel and CO2 emissions.”

*  Coombs NJ, Coombs JM, Vaidya UJ, et al. Environmental and social benefits of the targeted intraoperative radiotherapy for breast cancer: data from the UK TARGIT-A trial centres and to UK NHS hospitals offering TARGIT IORT. BMJ Open 2016; 6:e010703. doi:10.1136/bmjopen-2015010703.

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