One Week Adjuvant Radiotherapy for Breast Cancer
A Prospective Study of One Week Accelerated Hypo-fractionation Adjuvant Radiotherapy in High-risk Breast Cancer Patients
- Cancer is the second leading cause of death after cerebrovascular strokes and is a significant obstacle to each nation's future growth.
- Worldwide, Breast cancer is the most common cancer in women and the 5th leading cause of cancer related deaths that comes after lung cancer, colorectal cancer, liver cancer and gastric cancer.
- More than half of all breast cancer cases in the world occur in developing countries. Egypt has a high mortality rate from breast cancer, with a rate of 21.3 per 100,000 cases. Breast cancer is diagnosed at an advanced stage in 60 to 70% of cases in Egypt. The median age at diagnosis in Egypt is 48.5 years, which seems to be a decade younger than in Europe and North America.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Nahla M Elmahdy, assistant lecturer
- Phone Number: 01026886840
- Email: nahla.youssif@med.sohag.edu.eg
Study Locations
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Sohag, Egypt
- Recruiting
- Sohag university hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Female patients 45 years of age or older who have had Oncoplastic Breast Surgery (OBS) or total mastectomy with adequate axillary clearance and a negative margin.
- Breast carcinomas that is invasive (TXN1-3M0, T0N2-3 M0, T1N2-3M0, T2N2-3M0, T3N0-3M0, T4N0-3M0) whatever type of tumors biology.
- All patients with locally advanced breast cancer who received neoadjuvant chemotherapy and underwent either oncoplastic breast surgery or modified radical mastectomy
Exclusion Criteria:
- Metastatic breast cancer at the time of diagnosis proved clinically or radiologically.
- Postoperative positive margin.
- Carcinomas in situ.
- Mesenchymal breast lesions.
- Locoregional recurrent breast cancer.
- Synchronous bilateral breast cancer.
- very early breast cancer (T1-2N0M0,T1N1M0).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: Hypofractionation control arm
Patients who will receive 40 Gy in 15 fractions to the entire breast or chest wall over three weeks and have had breast conservation surgery (BCS) or oncoplastic breast surgery(OBS) will receive an additional boost to the tumour site if and will receive sequential dose 12GY\4 fractions or SIB 8GY 15 fractions.
The supraclavicular fossa will be treated in patients with node-positive disease or those who had received neoadjuvant chemotherapy .
The IMLN will be irradiated in N2and N3 at first presentation.
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Patients will receive 40 Gy in 15 fractions to the entire breast and or chest wall over the course of 3 weeks.
Other Names:
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Experimental: . Ultrahypofractionation experimental arm
Patients who will receive 26 Gy in 5 fractions to the entire breast and or chest wall for one week only.
The volume of this arm will be the same as the volume of the control arm as regard axillary nodes, supraclavicular and IMLN.
Patients who have had breast conservation or oncoplastic breast surgery(OBS) will be given a boost.
If a boost is given, SIB of 6 Gy in 5 fractions will be used (or a sequential boost of 12GY\4 fractions).
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Patients will receive 26 Gy in 5 fractions to the entire breast and or chest wall over the course of one week.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Acute toxicity
Time Frame: 3 months
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Rate of acute grade 2 toxicity or higher from the treatment till 3 months (NCI_CTCAE). Each patient will be assesed weekly during radiotherapy and monthly for 3 months post radiotherapy. |
3 months
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Chronic toxicity
Time Frame: 6 months post treatment up to 2 years
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Rate of chronic toxicity grade 2 or higher ( NCI_CTCAE) from 6 months after radiotherapy up to 2 years. Each patient will be assessed before treatment and at 6,12 and 24 months from treatment. |
6 months post treatment up to 2 years
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Local recurrence
Time Frame: Up to 2 years
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Rate of ipsilateral locoregional tumor recurrence proved by imaging and biopsy.
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Up to 2 years
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Patient compliance
Time Frame: From the starting point of treatment till the end of treatment ( 3 weeks in control arm and 1 week in experimental arm
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Compliance to treatment (number of interrupted days of radiotherapy.
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From the starting point of treatment till the end of treatment ( 3 weeks in control arm and 1 week in experimental arm
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall survival
Time Frame: From time of diagnosis up to 2 years post radiotherapy
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Overall survival (Number of the surviving patients for 2 years in each arm of the study)
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From time of diagnosis up to 2 years post radiotherapy
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.
- Gany F, Ayash C, Raad N, Wu M, Roberts-Eversley N, Mahmoud H, Fouad Y, Fahmy Y, Asar H, Salama A, El-Shinawi M. Financial and food security challenges of Egyptian women undergoing breast cancer treatment. Support Care Cancer. 2020 Dec;28(12):5787-5794. doi: 10.1007/s00520-020-05426-9. Epub 2020 Mar 27.
- Momenimovahed Z, Salehiniya H. Epidemiological characteristics of and risk factors for breast cancer in the world. Breast Cancer (Dove Med Press). 2019 Apr 10;11:151-164. doi: 10.2147/BCTT.S176070. eCollection 2019.
- Stapleton SM, Oseni TO, Bababekov YJ, Hung YC, Chang DC. Race/Ethnicity and Age Distribution of Breast Cancer Diagnosis in the United States. JAMA Surg. 2018 Jun 1;153(6):594-595. doi: 10.1001/jamasurg.2018.0035.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Soh-Med-21_10_18
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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