Radiation Therapy in Treating Women With Early-Stage Breast Cancer Who Have Undergone Breast Conservation Surgery
Recruitment status was Recruiting
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Purpose
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Giving radiation therapy after surgery may kill any tumor cells that remain after surgery. It is not yet known whether intensity-modulated radiation therapy is more effective than standard radiation therapy in treating patients with early-stage breast cancer.
PURPOSE: This randomized phase III trial is comparing radiation therapy regimens in treating women with early-stage breast cancer who have undergone breast-conservation surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Breast Cancer |
Radiation: radiation therapy |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Primary Purpose: Treatment |
| Official Title: | Randomised Trial Testing Intensity Modulated and Partial Organ Radiotherapy After Breast Conservation Surgery for Early Breast Cancer |
- Local tumor control in the ipsilateral breast (i.e., true recurrence plus new primary tumor) as confirmed by cytological or histological assessment [ Designated as safety issue: No ]
- Location of tumor relapse [ Designated as safety issue: No ]
- Contralateral primary breast cancer or other primary tumors as confirmed by cytological or histological assessment [ Designated as safety issue: No ]
- Regional and distant metastases [ Designated as safety issue: No ]
- Late adverse effects in normal tissues as determined periodically by photographic assessments (in a subset of patients), physician assessments, and patient self-assessments [ Designated as safety issue: Yes ]
- Quality of life as assessed by EORTC QLQ C-30, EORTC QLQ-BR23, BIS, and HADS questionnaires in a subset of patients at baseline, 6 months, and 1, 2, and 5 years [ Designated as safety issue: No ]
- Cost-effectiveness as assessed by EQ-5D questionnaire at baseline, 6 months, and 1, 2, and 5 years [ Designated as safety issue: No ]
| Estimated Enrollment: | 1935 |
| Study Start Date: | October 2006 |
| Estimated Primary Completion Date: | June 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Arm I (control)
Patients undergo standard whole breast radiotherapy once daily on days 1-5 for 3 weeks.
|
Radiation: radiation therapy
Patients undergo standard whole breast, reduced whole breast, or standard partial breast radiotherapy
|
|
Experimental: Arm II
Patients undergo reduced whole breast radiotherapy and standard partial breast radiotherapy once daily on days 1-5 for 3 weeks.
|
Radiation: radiation therapy
Patients undergo standard whole breast, reduced whole breast, or standard partial breast radiotherapy
|
|
Experimental: Arm III
Patients undergo standard partial breast radiotherapy once daily on days 1-5 for 3 weeks.
|
Radiation: radiation therapy
Patients undergo standard whole breast, reduced whole breast, or standard partial breast radiotherapy
|
Detailed Description:
OBJECTIVES:
- To test partial breast radiotherapy using intensity-modulated techniques following complete local tumor excision in women with low-risk, early stage breast cancer.
OUTLINE: This is a multicenter study.
Patients are stratified according to center (not participating in sub-studies vs participating in sub-studies). Patients are randomized to 1 of 3 treatment arms.
- Arm I (control): Patients undergo standard whole breast radiotherapy once daily on days 1-5 (15 fractions) for 3 weeks.
- Arm II: Patients undergo reduced whole breast radiotherapy (15 fractions) and standard partial breast radiotherapy (15 fractions) once daily on days 1-5 for 3 weeks.
- Arm III: Patients undergo standard partial breast radiotherapy once daily on days 1-5 (15 fractions) for 3 weeks.
All patients complete a family history questionnaire at baseline. Patients also undergo blood sample collection at baseline and paraffin-embedded tissue collection at follow-up for molecular studies analyzing inter-patient variation by microarrays.
Patients in centers participating in sub-studies undergo quality of life and health economic assessment at baseline, 6 months, and 1, 2, and 5 years. These patients also undergo photographic assessment at baseline, 2 years, and 5 years.
After completion of study treatment, patients are followed for 10 years.
Eligibility| Ages Eligible for Study: | 50 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Diagnosis of low-risk early stage breast cancer, meeting the following criteria:
Invasive adenocarcinoma
- No invasive carcinoma of classical lobular type
- No lymphovascular invasion
- Tumor size pathologically determined to be ≤ 3.0 cm in diameter (pT1-2) (< 3.1 cm maximum microscopic diameter of invasive component)
- Unifocal disease
- Grade I, II, or III disease
Axillary lymph nodes negative (pN0)
- Sentinel lymph node biopsy and isolated tumor cells < 0.2 mm allowed
Must have undergone breast conservation surgery with or without adjuvant systemic therapy
- Minimum microscopic margin of non-cancerous tissue ≥ 2 mm (excluding deep margin if this is at deep fascia)
- At low risk of local recurrence after radiotherapy (< 1% annual risk local recurrence)
- No prior mastectomy
- No blood-borne metastases
PATIENT CHARACTERISTICS:
- No prior malignancy except nonmelanoma skin cancer
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
No prior endocrine therapy or chemotherapy
- Neoadjuvant endocrine therapy allowed provided the tumour is < 3.0 cm and all other inclusion criteria are met
- No primary endocrine therapy as a replacement for surgery
- No concurrent chemoradiotherapy
Contacts and Locations| United Kingdom | |
| Royal Marsden - Surrey | Recruiting |
| Sutton, England, United Kingdom, SM2 5PT | |
| Contact: John R. Yarnold, MD, FRCR 44-20-8661-3388 | |
| Principal Investigator: | John R. Yarnold, MD, FRCR | Royal Marsden NHS Foundation Trust |
More Information
Additional Information:
No publications provided
| ClinicalTrials.gov Identifier: | NCT00814567 History of Changes |
| Other Study ID Numbers: | CDR0000629768, ICR-IMPORT-LOW, ICR-CTSU/2006/10001, ISRCTN12852634, EU-20896 |
| Study First Received: | December 24, 2008 |
| Last Updated: | January 6, 2011 |
| Health Authority: | Unspecified |
Keywords provided by National Cancer Institute (NCI):
|
recurrent breast cancer stage IA breast cancer stage II breast cancer invasive ductal breast carcinoma invasive ductal breast carcinoma with predominant intraductal component |
Additional relevant MeSH terms:
|
Breast Neoplasms Neoplasms by Site Neoplasms Breast Diseases Skin Diseases |
ClinicalTrials.gov processed this record on May 21, 2013