ArticleBMJ open2017
Health economics of targeted intraoperative radiotherapy (TARGIT-IORT) for early breast cancer: a cost-effectiveness analysis in the United Kingdom.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Under-reporting of Validation Efforts for Health Economic Models Persists Despite the Availability of Validation Tools: A Systematic Review.PharmacoEconomics · 2025Pooled it
- Pooled it
- Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System-A Systematic Review and First Bulgarian Experience in Breast Cancer Patients.Current oncology (Toronto, Ont.) · 2021Pooled it
- Partial breast irradiation versus whole breast radiotherapy for early breast cancer.The Cochrane database of systematic reviews · 2021Pooled it
- 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
- Cardiovascular events and mortality after breast cancer diagnosis: multistate models in a nationwide cohort study.BMJ open · 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
- 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
- Experience with intraoperative radiation therapy in an urban cancer center.Radiation oncology (London, England) · 2023Article
- Intraoperative Radiation Therapy: A Large Integrated Health Care System's Approach and Outcomes.The Permanente journal · 2023Article
- Review
- Case Report: Intraoperative radiotherapy as the new standard of care for breast cancer patients with disabling health conditions or impairments.Frontiers in oncology · 2023Article
- Prospective Comparison of Hypofractionated Versus Normofractionated Intensity-Modulated Radiotherapy in Breast Cancer: Late Toxicity Results of the Non-Inferiority KOSIMA Trial (ARO2010-3).Frontiers in oncology · 2022Article
- Global adoption of single-shot targeted intraoperative radiotherapy (TARGIT-IORT) for breast cancer-better for patients, better for healthcare systems.Frontiers in oncology · 2022Article
- Long-Term Outcomes of an International Cooperative Study of Intraoperative Radiotherapy Upfront Boost With Low Energy X-Rays in Breast Cancer.Frontiers in oncology · 2022Article
- Intraoperative radiotherapy versus whole-breast external beam radiotherapy, and other factors associated with the prognosis of early breast cancer treated with breast-conserving surgery and radiotherapy: a retrospective study from SEER database.Translational cancer research · 2020Article
- Cost-effectiveness analysis of intraoperative radiation therapy versus external beam radiation therapy for the adjuvant treatment of early breast cancer: A systematic review.Medical journal of the Islamic Republic of Iran · 2020Review
- Intraoperative Radiotherapy for Breast Cancer Treatment in a Rural Community.Annals of surgical oncology · 2018Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 4 countries.
Funding
Abstract
objectiveThe clinical effectiveness of targeted intraoperative radiotherapy (TARGIT-IORT) has been confirmed in the randomised TARGIT-A (targeted intraoperative radiotherapy-alone) trial to be similar to a several weeks' course of whole-breast external-beam radiation therapy (EBRT) in patients with early breast cancer. This study aims to determine the cost-effectiveness of TARGIT-IORT to inform policy decisions about its wider implementation.
settingTARGIT-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.
methodsCost-utility analysis using decision analytic modelling by a Markov model. A cost-effectiveness Markov model was developed using TreeAge Pro V.2015. The decision analytic model compared two strategies of radiotherapy for breast cancer in a hypothetical cohort of patients with early breast cancer based on the published health state transition probability data from the TARGIT-A trial. Analysis was performed for UK setting and National Health Service (NHS) healthcare payer's perspective using NHS cost data and treatment outcomes were simulated for both strategies for a time horizon of 10 years. Model health state utilities were drawn from the published literature. Future costs and effects were discounted at the rate of 3.5%. To address uncertainty, one-way and probabilistic sensitivity analyses were performed.
main outcome measuresQuality-adjusted life-years (QALYs).
resultsIn the base case analysis, TARGIT-IORT was a highly cost-effective strategy yielding health gain at a lower cost than its comparator EBRT. Discounted TARGIT-IORT and EBRT costs for the time horizon of 10 years were £12 455 and £13 280, respectively. TARGIT-IORT gained 0.18 incremental QALY as the discounted QALYs gained by TARGIT-IORT were 8.15 and by EBRT were 7.97 showing TARGIT-IORT as a dominant strategy over EBRT. Model outputs were robust to one-way and probabilistic sensitivity analyses.
conclusionsTARGIT-IORT is a dominant strategy over EBRT, being less costly and producing higher QALY gain. TRIAL REGISTRATION NUMBER: ISRCTN34086741; post results.
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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.