- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00005588
Radiation Therapy After Surgery in Treating Women With Early Stage Breast Cancer
Standardization of Breast Radiotherapy: Trial A - A Randomized Comparison of Fractionation Regimens After Local Excision or Mastectomy in Women With Early Stage Breast Cancer
RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known which regimen of radiation therapy is more effective following surgery for breast cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of two different regimens of radiation therapy following surgery in treating women who have early stage breast cancer.
Study Overview
Detailed Description
OBJECTIVES:
- Determine the benefits of radiotherapy schedules using fraction sizes larger than 2.0 Gy in terms of normal tissue responses, local-regional tumor control, quality of life, and economic consequences in women prescribed postoperative radiotherapy for early stage breast cancer.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to center, type of surgery (mastectomy vs local excision), and breast boost (yes vs no). Patients are randomized to 1 of 3 treatment arms.
- Arm I: Patients receive radiotherapy 5 times a week for 5 weeks for a total dose of 50 Gy.
- Arm II: Patients receive radiotherapy 5 times a fortnight (i.e., Monday/Wednesday/Friday/Tuesday/Thursday/Monday, etc.) for 13 fractions over 5 weeks for a total dose of 41.6 Gy.
- Arm III: Patients receive radiotherapy as in arm II for a total dose of 39 Gy. A breast boost is recommended in all arms for patients with microscopic evidence of invasive or in situ cancer at, or within 1 mm of, a resection margin. These patients receive radiotherapy for 5 fractions in 1 week for a total boost dose of 10 Gy.
Quality of life is assessed at baseline and then at 6, 12, 24, and 60 months.
Patients are followed annually for up to 20 years.
PROJECTED ACCRUAL: A total of 2,010 patients (670 per arm) will be accrued for this study.
Study Type
Phase
- Phase 3
Contacts and Locations
Study Locations
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Carlisle, United Kingdom, CA2 7HY
- Cumberland Infirmary
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Portsmouth Hants, United Kingdom, PO3 6AD
- Saint Mary's Hospital
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Preston, United Kingdom, PR2 9HT
- Royal Preston Hospital
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England
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Brighton, England, United Kingdom, BN2 5BE
- Royal Sussex County Hospital
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Cambridge, England, United Kingdom, CB2 2QQ
- Addenbrooke's NHS Trust
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Cheltenham, England, United Kingdom, GL53 7AN
- Cheltenham General Hospital
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Exeter, England, United Kingdom, EX2 5DW
- Royal Devon and Exeter Hospital
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Guildford, England, United Kingdom, GU2 5XX
- Royal Surrey County Hospital
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Ipswich, England, United Kingdom, IP4 5PD
- Ipswich Hospital NHS Trust
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Leicester, England, United Kingdom, LE1 5WW
- University Hospitals of Leicester
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London, England, United Kingdom, SE1 9RT
- Guy's and St. Thomas' Hospitals Trust
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Maidstone, England, United Kingdom, ME16 9QQ
- Maidstone Hospital
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Manchester, England, United Kingdom, M20 4BX
- Christie Hospital N.H.S. Trust
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Merseyside, England, United Kingdom, L63 4JY
- Clatterbridge Centre for Oncology NHS Trust
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Middlesbrough, Cleveland, England, United Kingdom, TS4 3BW
- South Tees Hospitals NHS Trust
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Midhurst, England, United Kingdom, GU29 OBL
- King Edward VII Hospital
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Northwood, England, United Kingdom, HA6 2RN
- Mount Vernon Hospital
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Norwich, England, United Kingdom, NR1 3SR
- Norfolk & Norwich Hospital
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Nottingham, England, United Kingdom, NG5 1PB
- Nottingham City Hospital NHS Trust
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Plymouth, England, United Kingdom, PL6 8DH
- Derriford Hospital
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Reading, England, United Kingdom, RG1 5AN
- Royal Berkshire Hospital
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Romford, England, United Kingdom, RM7 OBE
- Oldchurch Hospital
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Sheffield, England, United Kingdom, S1O 2SJ
- Weston Park Hospital
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Shrewsbury, England, United Kingdom
- Royal Shrewsbury Hospital
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Stoke-On-Trent, England, United Kingdom, ST4 7LN
- North Staffs Royal Infirmary
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Sutton, England, United Kingdom, SM2 5PT
- Royal Marsden Hospital
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Torquay Devon, England, United Kingdom, TQ2 7AA
- Torbay Hospital
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Westcliff-On-Sea, England, United Kingdom
- Southend NHS Trust Hospital
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Wolverhampton, England, United Kingdom, WV10 0QP
- New Cross Hospital
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Northern Ireland
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Belfast, Northern Ireland, United Kingdom, BT8 8JR
- Belfast City Hospital Trust Incorporating Belvoir Park Hospital
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Scotland
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Dundee, Scotland, United Kingdom, DD1 9SY
- Ninewells Hospital and Medical School
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Wales
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Cardiff, Wales, United Kingdom, CF4 7XL
- Velindre Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Histologically confirmed invasive unilateral breast cancer that is considered operable
- T1-3, N0-1, M0 at presentation
- Complete macroscopic excision of tumor by breast conserving surgery or mastectomy
- No immediate breast reconstruction
- No requirement for axillary radiotherapy after greater than a Level 1 axillary dissection or after greater than 10 lymph nodes have been removed
- Not enrolled on SECRAB or OSCAR trials
Hormone receptor status:
- Not specified
PATIENT CHARACTERISTICS:
Age:
- 18 and over
Sex:
- Female
Menopausal status:
- Not specified
Performance status:
- Not specified
Life expectancy:
- Not specified
Hematopoietic:
- Not specified
Hepatic:
- Not specified
Renal:
- Not specified
PRIOR CONCURRENT THERAPY:
- Prior neoadjuvant, or primary medical, therapy allowed provided subsequent surgery confirms complete macroscopic excision of residual primary tumor
Biologic therapy:
- Not specified
Chemotherapy:
- At least 2 weeks since prior cytotoxic agents
- No concurrent chemotherapy
Endocrine therapy:
- Not specified
Radiotherapy:
- See Disease Characteristics
Surgery:
- See Disease Characteristics
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: John R. Yarnold, MD, FRCR, Royal Marsden NHS Foundation Trust
Publications and helpful links
General Publications
- Hopwood P, Haviland JS, Sumo G, Mills J, Bliss JM, Yarnold JR; START Trial Management Group. Comparison of patient-reported breast, arm, and shoulder symptoms and body image after radiotherapy for early breast cancer: 5-year follow-up in the randomised Standardisation of Breast Radiotherapy (START) trials. Lancet Oncol. 2010 Mar;11(3):231-40. doi: 10.1016/S1470-2045(09)70382-1. Epub 2010 Feb 6.
- Hopwood P, Haviland J, Mills J, Sumo G, M Bliss J; START Trial Management Group. The impact of age and clinical factors on quality of life in early breast cancer: an analysis of 2208 women recruited to the UK START Trial (Standardisation of Breast Radiotherapy Trial). Breast. 2007 Jun;16(3):241-51. doi: 10.1016/j.breast.2006.11.003. Epub 2007 Jan 19. Erratum In: Breast. 2008 Feb;17(1):115. START Trial Management Group [added].
- Venables K, Miles EA, Aird EG, Hoskin PJ; START Trial Management Group. The use of in vivo thermoluminescent dosimeters in the quality assurance programme for the START breast fractionation trial. Radiother Oncol. 2004 Jun;71(3):303-10. doi: 10.1016/j.radonc.2004.02.008.
Study record dates
Study Major Dates
Study Start
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CDR0000067662
- STMG-STARTA
- EU-99014
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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