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Fase II protokol for protonterapi til delvis brystbestråling i tidligt stadie af brystkræft

25. september 2026 opdateret af: Proton Collaborative Group

The purpose of this research study is to compare the effects (good and bad) on women and their cancer using proton radiation therapy.

This study is being done to see if proton radiation therapy will prove to be beneficial for women with early stage breast cancer. A clinical study is necessary to compare the results (good or bad) of proton radiation therapy.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Current standard of care for early stage breast cancer is mastectomy or breast conserving therapy with whole breast irradiation following lumpectomy. However, studies of breast cancer recurrence have demonstrated the majority of tumors to recur in or adjacent to the original tumor site. The question has thus been raised as to whether radiation to the whole breast is necessary or justified. Limiting radiation to the area of the original tumor may reduce acute and long-term skin and organ toxicities while making radiation therapy more convenient and less expensive. Several clinical trials are underway comparing partial breast irradiation (PBI) to whole breast irradiation. Numerous centers are offering partial breast irradiation outside of clinical trials as well, despite the lack of long-term safety and efficacy data on PBI.

Available PBI methods include brachytherapy, in which catheters or balloons are surgically inserted to deliver radiation therapy to the lumpectomy cavity, and conventional external beam radiation therapy, or EBRT. External beam photon therapy is attractive for its non-invasive nature and ability to deliver a more homogenous dose distribution compared to brachytherapy, however it also delivers a greater radiation dose to surrounding normal breast tissue.Proton therapy has the capacity to provide the same advantages as photon EBRT while minimizing dose to normal surrounding tissue. Clinical data on PBI with protons is minimal, however, leaving many questions unanswered. The impetus behind this protocol is to address these gaps by further investigating the feasibility, safety, and efficacy of proton therapy for partial breast irradiation.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

132

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Arizona
      • Scottsdale, Arizona, Forenede Stater, 85259
        • Rekruttering
        • Mayo Clinic
        • Ledende efterforsker:
          • Carlos Vargas, MD
        • Kontakt:
    • California
      • San Diego, California, Forenede Stater, 92121
        • Rekruttering
        • California Protons Cancer Therapy Center
        • Kontakt:
        • Ledende efterforsker:
          • James Urbanic, MD
    • Illinois
      • Warrenville, Illinois, Forenede Stater, 60555
        • Rekruttering
        • Northwestern Medicine Chicago Proton Center
        • Kontakt:
        • Ledende efterforsker:
          • Arpi Thukral, MD
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21201
        • Rekruttering
        • Maryland Proton Treatment Center
        • Kontakt:
        • Ledende efterforsker:
          • Elizabeth Nichols, MD
    • Michigan
      • Flint, Michigan, Forenede Stater, 48532
        • Rekruttering
        • McLaren Proton Therapy Center
        • Kontakt:
        • Ledende efterforsker:
          • Brian Yeh, MD
    • New York
      • New York, New York, Forenede Stater, 10035
        • Rekruttering
        • New York Proton Center
        • Kontakt:
        • Ledende efterforsker:
          • Isabelle Choi, MD
    • Oklahoma
      • Oklahoma City, Oklahoma, Forenede Stater, 73142
        • Rekruttering
        • Oklahoma Proton Center
        • Ledende efterforsker:
          • John Chang, MD
        • Kontakt:
    • Virginia
      • Fairfax, Virginia, Forenede Stater, 22031
        • Rekruttering
        • Inova Schar Cancer Institute
        • Kontakt:
        • Ledende efterforsker:
          • Ashish Chawla, MD
      • Hampton, Virginia, Forenede Stater, 23666
        • Rekruttering
        • Hampton University Proton Therapy Institute
        • Kontakt:
        • Ledende efterforsker:
          • Christopher Sinesi, MD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

50 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Kvinde

Beskrivelse

Inclusion Criteria:

  • Must sign study-specific, IRB approved informed consent form prior to study entry. Note consent by legally authorized representative is not allowed for this trial.

  • Must be female.

  • Must be > = 50 years of age.

  • Must have a life expectancy of at least 5 years based on age and co-morbidities.

  • Must have pathology proven invasive ductal carcinoma (lobular is not allowed) and/or ductal carcinoma in situ (DCIS).

  • One of the following criteria must be met: (a) Tumors that are microscopically multifocal must be 3.0 cm or less in total aggregate size and encompassed within a single scar (b) Patient does not have microscopically multifocal tumor.

  • For tumors that are invasive, if in the presence of extensive intraductal component (EIC), the entire pathologic tumor size (including both the intraductal and invasive component) must be 3.0 cm or less.

  • Must be Stage 0, I, II (Tis, T1, or T2, N0, M0 per AJCC criteria 7th and/or 8th Ed.). If stage II, the tumor size must be < = 3.0 cm. A patient with invasive histology must have nodal stage pN0 by H&E stains on sentinel node biopsy or axillary lymph node dissection.

  • Must have ER positive disease with ER/PR report available.

  • For tumors that are invasive, HER2 must be performed (positive or negative is acceptable).

  • Must have a lumpectomy performed, with documented negative surgical margins by 0.2 cm or more. If re-excision results in negative surgical margins 0.2 cm or more, patient is eligible.

  • If image guidance with daily cone beam CT with direct physician visual assessment is used for treatment positioning, the presence of markers or clips in the surgical bed is recommended but not required. If cone beam CT imaging will NOT be used for image guidance, then the patient must be prepared to have 2 fiducial markers minimum, 3 preferred, placed prior to treatment (if not previously done).

    • If markers or clips were placed at the time of surgery, patient must be able to start treatment within 12 weeks after lumpectomy or re-excision for adequate margins.
    • If markers were not placed at the time of surgery and are needed, patient must have markers placed within 6 weeks after surgery.
    • If systemic chemotherapy was given, patient must have had clips or markers placed at the time of surgery (if they are needed) and patient must have simulation scans within 6 weeks of the completion of the chemotherapy.

  • Must be able to start treatment within 12 weeks of surgery or 8 weeks of finalization of chemotherapy.

Exclusion Criteria:

  • Previous history of ipsilateral invasive breast cancer or DCIS.
  • Any clinical or radiographically suspicious nodes, unless biopsy proven benign.
  • Non-epithelial malignancies such as sarcoma or lymphoma.
  • Suspicious residual microcalcifications on mammography of either breast, unless negative for malignancy on pathology.
  • Multicentric or bilateral disease unless biopsy of the clinical abnormalities are performed and result is negative.
  • Lymphovascular space invasion (LVSI) on pathology specimen.
  • Any previously treated breast carcinoma or synchronous breast carcinoma in ipsilateral breast.
  • Prior radiation therapy to the ipsilateral breast or thorax.
  • Paget's disease of the nipple.
  • Histologic examination showing invasive lobular histology.
  • Skin involvement.
  • Breasts technically unsatisfactory for radiation treatment upon the discretion of the treating physician.
  • Significant infection or other co-existing medical condition that would preclude protocol therapy such as pregnancy, HIV/AIDS or collagen vascular diseases specifically systemic lupus erythematosus, scleroderma, or dermatomyositis.
  • Known BRCA 1 or BRCA 2 mutation.
  • Pregnant or lactating.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Proton Radiotherapy

Proton Radiotherapy 4.0 Gy (RBE) x10 fractions to 40 Gy (RBE) Total Dose
Stråling: Protonstrålebehandling

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
To assess events of freedom from ipsilateral breast recurrence occurrences in patients receiving partial breast proton radiation therapy limited to the region of the tumor.
Tidsramme: At 3 years

Freedom from failure (FFF): The events for FFF will be the first ipsilateral breast cancer recurrence. It is expected that less than 3% of patients will experience an ipsilateral breast cancer recurrence (FFF ≥ 97%). A recurrence rate of ≥ 10% (FFF ≤ 90%) is considered unacceptable. Therefore, the null hypothesis is the FFF of ipsilateral breast cancer recurrence is 90% or lower and the alternative hypothesis is that FFF of ipsilateral breast cancer is 97% or higher.
At 3 years

Sekundære resultatmål

Resultatmål
Tidsramme
Vurder antallet og sværhedsgraden af ​​akut og langsigtet toksicitet af delvis brystbestråling ved hjælp af protonterapi til behandling af tidligt stadium af brystkræft.
Tidsramme: I gennemsnit hver 6. måned hele livet
I gennemsnit hver 6. måned hele livet
At vurdere sammenhængen mellem bryststørrelse og delvis brystdosimetri.
Tidsramme: Gennemsnit hver 6. måned i 3 år
Gennemsnit hver 6. måned i 3 år
Bestem resultater for livskvalitet.
Tidsramme: Gennemsnit hver 6. måned i 3 år
Gennemsnit hver 6. måned i 3 år
At bestemme den samlede overlevelsesrate for patienter med brystkræft behandlet med protonstråling.
Tidsramme: På 3 år
På 3 år
At bestemme tilbagefaldsmønsteret for patienter med brystkræft behandlet med protonpartiel brystbestråling.
Tidsramme: På 3 år
På 3 år

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Proton Collaborative Group

Efterforskere

  • Studiestol: Andrew Chang, MD, Proton Collaborative Group

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. februar 2013

Primær færdiggørelse (Anslået)

1. januar 2027

Studieafslutning (Anslået)

1. januar 2035

Datoer for studieregistrering

Først indsendt

28. december 2012

Først indsendt, der opfyldte QC-kriterier

9. januar 2013

Først opslået (Anslået)

11. januar 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

29. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • BRE007-12

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