ArticleBMJ open2016
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.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 86 citations in OpenAlex.
- Intraoperative radiotherapy in elderly patients with breast cancer: long-term follow-up results of the prospective phase II trial TARGIT-E.BMC cancer · 2025Trial
- Long term survival and local control outcomes from single dose targeted intraoperative radiotherapy during lumpectomy (TARGIT-IORT) for early breast cancer: TARGIT-A randomised clinical trial.BMJ (Clinical research ed.) · 2020Trial
- Intraoperative Radiotherapy for Breast Cancer: Long-Term Experience.Annals of surgical oncology · 2026Article
- Viewpoint: Optimising Cancer Treatment to Reduce Its Environmental Impact.Journal of medical imaging and radiation oncology · 2026Article
- A novel methodology using direct patient contact and UK national registries to collect long-term data from randomised trials: TARGIT-X - an extended follow-up study of the TARGIT-A trial of targeted intraoperative radiotherapy for breast cancer.Health technology assessment (Winchester, England) · 2026Article
- Effectiveness of Interventions to Reduce Carbon-Emissions Within Secondary Healthcare: Systematic Review and Evidence and Gap Map.Campbell systematic reviews · 2025Review
- Quantifying the Carbon Footprint of External Beam Radiation Therapy-A Narrative Review.Journal of medical radiation sciences · 2025Review
- Immunological and Clinical Impacts of Targeted Intraoperative Radiotherapy in Breast Cancer: A Narrative Review.Cureus · 2025Review
- The evolution of targeted intra operative radiotherapy in early breast cancer.Journal of cancer research and clinical oncology · 2025Review
- Stepping Stones to Sustainability Within Cancer Clinical Trials in Ireland.Current oncology (Toronto, Ont.) · 2025Article
- Sustainability in radiation oncology: opportunities for enhancing patient care and reducing COStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- Financial Toxicity of Partial Versus Whole Breast Irradiation: A Systematic Review.Mayo Clinic proceedings. Innovations, quality & outcomes · 2025Review
- Travel burden and carbon dioxide emission reductions through a model of cancer care closer to the patient.The oncologist · 2025Article
- Saving lives, saving earth: hypofractionation and carbon footprint.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Article
- Article
- Methodological guide for assessing the carbon footprint of external beam radiotherapy: A single-center study with quantified mitigation strategies.Clinical and translational radiation oncology · 2024Article
- Modelling the Costs of Sublingual Immunotherapy versus Subcutaneous Immunotherapy Based on Clinical Appointments and Impacts of Patient Travel in Sweden.ClinicoEconomics and outcomes research : CEOR · 2024Article
- Case report: IORT as an alternative treatment option for breast cancer patients with difficulty staying still.Frontiers in oncology · 2024Article
- A single-institution retrospective analysis of intraoperative radiation boost during breast-conservation treatment for breast cancer.Journal of cancer research and clinical oncology · 2023Article
- Intraoperative Radiation Therapy: A Large Integrated Health Care System's Approach and Outcomes.The Permanente journal · 2023Article
Corrections and comments
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Authors and funding
20 authors at 10 institutions in 4 countries.
Funding
Abstract
objectiveTo quantify the journeys and CO2 emissions if women with breast cancer are treated with risk-adapted single-dose targeted intraoperative radiotherapy (TARGIT) rather than several weeks' course of external beam whole breast radiotherapy (EBRT) treatment.
setting(1) TARGIT-A randomised clinical trial (ISRCTN34086741) which compared TARGIT with traditional EBRT and found similar breast cancer control, particularly when TARGIT was given simultaneously with lumpectomy, (2) 2 additional UK centres offering TARGIT.
participants485 UK patients (249 TARGIT, 236 EBRT) in the prepathology stratum of TARGIT-A trial (where randomisation occurred before lumpectomy and TARGIT was delivered simultaneously with lumpectomy) for whom geographical data were available and 22 patients treated with TARGIT after completion of the TARGIT-A trial in 2 additional UK breast centres. OUTCOME MEASURES: The shortest total journey distance, time and CO2 emissions from home to hospital to receive all the fractions of radiotherapy.
methodsDistances, time and CO2 emissions were calculated using Google Maps and assuming a fuel efficiency of 40 mpg. The groups were compared using the Student t test with unequal variance and the non-parametric Wilcoxon rank-sum (Mann-Whitney) test.
resultsTARGIT patients travelled significantly fewer 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 spent less time travelling: 3 h (SE 0.53) vs 14 h (SE 0.76), all p<0.0001. Patients treated with TARGIT in 2 hospitals in semirural locations were spared much longer journeys (753 miles, 30 h, 215 kg CO2 per patient).
conclusionsThe use of TARGIT intraoperative radiotherapy for eligible patients with breast cancer significantly reduces their journeys for treatment and has environmental benefits. If widely available, 5 million miles (8 000 000 km) of travel, 170 000 woman-hours and 1200 tonnes of CO2 (a forest of 100 hectares) will be saved annually in the UK. TRIAL REGISTRATION NUMBER: ISRCTN34086741; Post-results.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.