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Effect of Radiation and Its Timing on Breast Reconstruction in Chinese Patients

14. november 2018 opdateret af: Tianjin Medical University Cancer Institute and Hospital

A Multi-center Prospective Observational Trial Investigating the Effect of Radiation and Its Timing on Breast Reconstruction in Chinese Patients

The purpose of the study is to investigate the impacts of radiation and the timing of radiation on autologous and prosthetic-based breast reconstruction in Chinese post-mastectomy breast cancer patients. The study aims to optimize the timing for autologous/prosthetic breast reconstruction which delivers the best aesthetic results while maintains low complication rate and best integrates into the comprehensive breast cancer treatment. The study is open to all female breast cancer patients undergoing breast reconstruction in the department of breast reconstruction in Tianjin medical university cancer institute and hospital.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

In breast cancer patients, post-operative radiation therapy is an important component in breast cancer management. However, in the context of breast reconstruction, radiation can have adverse effect as it increases the rate of fat necrosis and leads to fibrosis/ capsular contracture in the reconstructed breast mounds. It is therefore necessary to investigate the best timing for breast reconstruction, especially in those patients which post-operative radiation is required, which does not interfere with overall breast cancer treatment while produces the best surgical, aesthetic and psychological outcome. Most studies in this field are retrospective, and studies on Chinese cohort are also rare. This multi-center prospectively designed clinical trial will include several medical centers across China. The investigators will allocate the patients into three arms based on the status and sequence of radiation and breast reconstruction, and will further stratify the groups based on the different approaches of reconstruction (autologous/ prosthetic based). Both objective and subjective (patient oriented) methods will be employed to make evaluations involving surgical, aesthetic, and psychological outcomes.

Undersøgelsestype

Observationel

Tilmelding (Forventet)

1344

Kontakter og lokationer

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

Studiekontakt

  • Navn: Shanshan He
  • Telefonnummer: 1174 +86-22-23340123
  • E-mail: ssh85@yahoo.com

Undersøgelse Kontakt Backup

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

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Kvinde

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Study population include female Chinese breast cancer patients who wish to undergo autologous or prosthetic-based breast reconstruction.

Beskrivelse

Inclusion Criteria:

  • Diagnosed with breast cancer
  • Karnofsky Performance Status (KPS) larger than 70
  • Underwent autologous or prosthetic based breast reconstruction
  • No severe deficiency in hematological, cardiovascular system, no immune-deficiency, no severe abnormal liver or kidney function.

Exclusion Criteria:

  • Metastatic breast cancer
  • Local recurrence after mastectomy
  • Prior radiation history to chest wall due to other tumors
  • Radiation performed more than 6 months after mastectomy
  • Interruption of radiation more than 2 weeks
  • Gravida or during lactation
  • Concurrently undergoing psychotic disorders

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
BR group
Breast reconstruction without radiation therapy
Procedure: Immediate Breast reconstruction
Immediate Autologous/prosthetic-based breast reconstruction is performed after mastectomy on the breast that is diagnosed with breast cancer
Procedure: Delayed Breast Reconstruction
Delayed Autologous/prosthetic-based breast reconstruction is performed after mastectomy on the breast that is diagnosed with breast cancer
Immediate BR +post-op radiation
Immediate breast reconstruction followed by surgical site radiation therapy
Procedure: Immediate Breast reconstruction
Immediate Autologous/prosthetic-based breast reconstruction is performed after mastectomy on the breast that is diagnosed with breast cancer
Stråling: Radiation
Radiation is performed to the surgical site and complies with the ASCO guidelines on post-mastectomy radiotherapy
Radiation +delayed BR
previous post-mastectomy radiation followed by delayed breast reconstruction
Procedure: Delayed Breast Reconstruction
Delayed Autologous/prosthetic-based breast reconstruction is performed after mastectomy on the breast that is diagnosed with breast cancer
Stråling: Radiation
Radiation is performed to the surgical site and complies with the ASCO guidelines on post-mastectomy radiotherapy

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
occurrence of short term complications
Tidsramme: the short term complications will be inspected up to 3 months post-op;
impaired arterial or venous flap perfusion by increased (>3 seconds) or reduced (<2 seconds) capillary refill time; infection of the reconstructed breast with evidences from microbiological cultures; partial or entire flap necrosis with evident demarcation by clinical observation
the short term complications will be inspected up to 3 months post-op;
occurrence and change of long term complications
Tidsramme: the long term complications will be assessed at 6 months post-op; repeated assessments will be made at 12 and 24 months to record changes
fat necrosis proven by breast ultrasound/ breast MRI/ pathology; flap contracture that causes change in shape and/or volume in the reconstructed breast mound observed by naked-eye inspection or breast imaging; capsular contracture that causes hardness/pains or changes of the reconstructed breast mound observed by surgeon's inspection or breast imaging.
the long term complications will be assessed at 6 months post-op; repeated assessments will be made at 12 and 24 months to record changes
occurrence of secondary surgery
Tidsramme: up to 24 months post-op
unplanned surgery due to short-term and/or long-term complications post-op, the types of secondary surgery include but not limited to exploratory surgery, flap salvages, removal or fat necrosis, debridement, prosthetic explantation.
up to 24 months post-op

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
occurrence of revision surgery
Tidsramme: 6 to 24 months post-op
any surgery performed to the reconstructed or contralateral breast to optimize symmetry
6 to 24 months post-op
baseline and change of subjective evaluation
Tidsramme: the baseline evaluation will be made at 6 months post-op; repeated evaluations will be made at 12 and 24 months to record changes
patient oriented aesthetic, psychological and overall outcome evaluations are made with BREAST-Q (short for breast-questionnaire) post reconstruction module, the the selected questionnaire includes a set of questions regarding : category 1-patients' satisfaction with breasts; category 2-patients' satisfaction with outcome and category 3-patients' psychological well-being. In each category, the total score is generated by Q-score (short for questionnaire-score)software and the total score ranges from 0-100. The higher the score the better the satisfaction.
the baseline evaluation will be made at 6 months post-op; repeated evaluations will be made at 12 and 24 months to record changes

Samarbejdspartnere og efterforskere

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

Sponsor

Tianjin Medical University Cancer Institute and Hospital

Efterforskere

  • Ledende efterforsker: Jian Yin, Tianjin Medical University Cancer Institute and Hospital

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

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 (Forventet)

1. januar 2019

Primær færdiggørelse (Forventet)

1. november 2022

Studieafslutning (Forventet)

1. april 2023

Datoer for studieregistrering

Først indsendt

7. november 2018

Først indsendt, der opfyldte QC-kriterier

14. november 2018

Først opslået (Faktiske)

16. november 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

16. november 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

14. november 2018

Sidst verificeret

1. november 2018

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • E2018210

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

There is no plan to share IPD with other researchers.

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