- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00802711
3-Dimensional Conformal Radiation Therapy or Internal Radiation Therapy After Breast-Conserving Surgery in Treating Women With Stage I or Stage II Breast Cancer
Phase II Randomised Clinical Trial of Accelerated Partial Breast Irradiation (APBI) Comparing 3-Dimensional Conformal Radiation Therapy and Multi-Catheter Interstitial Brachytherapy.
RATIONALE: Specialized radiation therapy, such as 3-dimensional conformal radiation therapy, that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Internal radiation uses radioactive material placed directly into or near a tumor to kill tumor cells. Giving these treatments after surgery may kill any tumor cells that remain after surgery. It is not yet known whether 3-dimensional conformal radiation therapy is more effective than internal radiation therapy when given after surgery in treating early-stage breast cancer.
PURPOSE: This randomized phase II trial is studying 3-dimensional conformal radiation therapy to see how well it works compared with internal radiation therapy when given after breast-conserving surgery in treating women with stage I or stage II breast cancer.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
OBJECTIVES:
Primary
- To compare the rate of successfully delivered accelerated partial breast irradiation (APBI) using 3-dimensional conformal radiation therapy vs multi-catheter interstitial brachytherapy in women with stage I or II invasive ductal carcinoma of the breast.
- To establish potential patient participation in ongoing phase III clinical trials (e.g., NSABP-B-39, GEC-ESTRO, RAPID, MPORT, and IRMA) that compare APBI to standard whole-breast irradiation.
Secondary
- To assess acute radiation-induced toxicity in these patients as assessed by NCI CTCAE version 3.0.
- To assess long-term radiation-induced toxicity in these patients as assessed by RTOG-EORTC scale.
- To assess the incidence and type of adverse events in the breast of these patients.
- To assess the incidence and type of procedure-related complications in these patients.
- To determine local control and pattern of recurrence in these patients.
- To determine disease-free survival (distant and recurrence-free survival) of these patients.
- To determine overall survival of these patients.
- To assess cosmesis in these patients as assessed by the Breast Cancer Treatment Outcome and RTOG scales.
- To assess treatment-related symptoms in these patients as assessed by the Breast Cancer Treatment Outcome scale.
OUTLINE: Patients are randomized to 1 of 2 treatment arms. Patients with a lumpectomy cavity/whole breast ratio 25-30% are assigned to treatment in arm II.
- Arm I: Patients undergo accelerated partial breast irradiation (APBI) using 3-dimensional conformal radiation therapy twice daily over 5-10 days (total of 10 fractions) in the absence of disease progression or unacceptable toxicity.
- Arm II: Patients undergo APBI using multi-catheter interstitial brachytherapy twice daily over 5-10 days (total of 10 fractions) in the absence of disease progression or unacceptable toxicity.
Patients complete quality-of-life questionnaires at baseline, on the last day of treatment, at 4 and 24 weeks after completion of treatment, and then annually for 3 years.
After completion of study treatment, patients are followed periodically for at least 5 years.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Dublin, Ireland, 6
- Saint Luke's Radiation Oncology Network
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
DISEASE CHARACTERISTICS:
Pathologically proven invasive ductal carcinoma of the breast
Stage I or II disease (pathological tumor size ≤ 3 cm, N0, M0 disease)
- No T2 (tumor size > 3 cm) or T3 disease
- No lymph node (L0) or hemangiosis (V0) invasion
Unilateral, unifocal, and unicentric tumor without associated suspicious diffuse microcalcification in the ipsilateral or contralateral breast
- No multifocal/multicentric disease
Previously treated with breast-conserving surgery with adequate axillary node management
- Negative surgical resection margins for tumor (invasive tumor or ductal carcinoma in situ [DCIS]) on histology
Clearly identified primary tumor excision cavity (clips recommended) with a target lumpectomy cavity/whole breast ratio quantifiable and ≤ 25% on the post-operative CT scan
- Patients with a lumpectomy cavity/whole breast ratio 25-30% are eligible but will undergo partial breast irradiation using multi-catheter interstitial brachytherapy during study
- Breast size amenable to partial breast irradiation (i.e., > A-cup size)
- No other pathological invasive tumor or DCIS
- No associated extensive DCIS component (< 25%)
- No associated Paget's disease of the nipple
- Hormone receptor status not specified
PATIENT CHARACTERISTICS:
- Menopausal status not specified
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No breast implants
- No collagen vascular disease
- No psychiatric condition or other condition that, in the opinion of the investigator, would preclude study requirements
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No prior radiotherapy
No concurrent chemotherapy
- Sequential chemotherapy allowed
- Concurrent hormonal therapy allowed
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Arm I
Patients undergo accelerated partial breast irradiation (APBI) using 3-dimensional conformal radiation therapy twice daily over 5-10 days (total of 10 fractions) in the absence of disease progression or unacceptable toxicity.
|
Given twice a day for 10 fractions
|
|
Experimental: Arm II
Patients undergo APBI using multi-catheter interstitial brachytherapy twice daily over 5-10 days (total of 10 fractions) in the absence of disease progression or unacceptable toxicity.
|
Given twice a day for 10 fractions
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Rate of successfully delivered accelerated partial breast irradiation
Time Frame: Never established as trial terminated
|
Never established as trial terminated
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Local control and pattern of recurrence
Time Frame: Never established as trial terminated
|
Never established as trial terminated
|
|
Disease-free survival (distant and recurrence-free survival)
Time Frame: Never established as trial terminated
|
Never established as trial terminated
|
|
Overall survival
Time Frame: Never established as trial terminated
|
Never established as trial terminated
|
|
Quality of life (e.g., cosmesis and treatment-related symptoms) as assessed by the Breast Cancer Treatment Outcome and RTOG scales
Time Frame: Never established as trial terminated
|
Never established as trial terminated
|
|
Acute radiation-induced toxicity as assessed by NCI CTCAE v3.0
Time Frame: Never established as trial terminated
|
Never established as trial terminated
|
|
Long-term radiation-induced toxicity as assessed by RTOG-EORTC scale
Time Frame: Never established as trial terminated
|
Never established as trial terminated
|
|
Incidence and type of adverse events in the breast
Time Frame: Never established as trial terminated
|
Never established as trial terminated
|
|
Incidence and type of procedure-related complications
Time Frame: Never established as trial terminated
|
Never established as trial terminated
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Pierre Thirion, MD, Saint Luke's Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Neoplasms by Histologic Type
- Neoplasms, Glandular and Epithelial
- Adenocarcinoma
- Skin Diseases
- Breast Diseases
- Carcinoma
- Neoplasms, Ductal, Lobular, and Medullary
- Carcinoma, Ductal
- Skin and Connective Tissue Diseases
- Breast Neoplasms
- Carcinoma, Ductal, Breast
- Therapeutics
- Radiotherapy
- Radiotherapy, Computer-Assisted
- Brachytherapy
- Radiotherapy, Conformal
Other Study ID Numbers
- 06-33 ICORG
- ICORG-06-33
- EU-20888
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