Molecular Subtype-Guided Postoperative Radiotherapy for Phyllodes Tumor of the Breast: A Randomized Controlled Trial
Efficacy and Safety of Molecular Subtype-Guided Postoperative Radiotherapy for Phyllodes Tumor of the Breast: A Prospective, Open-Label, Randomized Controlled Trial
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- No aplica
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Yan Nie
- Número de teléfono: +86 020-81332587
- Correo electrónico: nieyan7@mail.sysu.edu.cn
Ubicaciones de estudio
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Guangdong
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Guangzhou, Guangdong, Porcelana, 510120
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
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Contacto:
- Yan Nie
- Número de teléfono: +86 020-81332587
- Correo electrónico: nieyan7@mail.sysu.edu.cn
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Shenzhen, Guangdong, Porcelana, 518000
- Peking University Shenzhen Hospital
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Contacto:
- Junwei Cui
- Número de teléfono: +86 13828832157
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Shandong
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Jinan, Shandong, Porcelana, 250033
- The Second Hospital of Shandong University
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Contacto:
- Fei Wang
- Número de teléfono: +86 17660083882
- Correo electrónico: fei.wang@sdu.edu.cn
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Qingdao, Shandong, Porcelana, 266003
- The Affiliated Hospital of Qingdao University
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Contacto:
- Haibo Wang
- Número de teléfono: +86 18661805787
- Correo electrónico: hbwang66@qdu.edu.cn
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Descripción
Inclusion Criteria:
- Female patients aged ≥18 years and ≤75 years.
- Histologically confirmed breast phyllodes tumor (PT) by the central laboratory, with molecular classification as MN1 or MN2 subtype via transcriptome sequencing or IHC;
- Primary or ipsilateral local recurrence following R0 resection (negative margins) before enrollment;
- Pathologically confirmed borderline or malignant PT;
- No evidence of distant metastasis (M0);
- ECOG performance status 0-1;
- Signed informed consent before treatment;
- Expected randomization and study entry within 8-12 weeks (no later than 16 weeks) after surgery.
Exclusion Criteria:
- Previous radiation to the same-side breast or chest;
- women, or those of childbearing potential refusing effective contraception; Pregnancy, lactation, or refusal of contraception by fertile subjects;
- Grade III-IV bone marrow suppression: WBC≤1.9*109/L,ANC≤0.9*109/L,PLT≤49*109/L,AST, ALT≥2*ULN;
- Significant diarrhea, severe active infection, uncontrolled systemic disease, interstitial lung disease, active connective tissue disease, or LVEF < 50%;
- Significant diarrhea, severe active infection, uncontrolled systemic disease, interstitial lung disease, active connective tissue disease, or LVEF < 50%;
- Prior or planned systemic anti-tumor therapy (chemotherapy, targeted therapy, immunotherapy, or investigational agents) during the study;
- Participation in other clinical trials that precludes study inclusion;
- Any other condition that, in the opinion of the investigator, renders the patient unsuitable for the trial.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
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Sin intervención: Observación
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Experimental: Postoperative Radiotherapy (PORT)
Patients receive postoperative radiotherapy starting within 8-12 weeks (max 16 weeks) after R0 resection.
For breast-conserving surgery: whole-breast irradiation (50 Gy/25 fractions) plus sequential tumor bed boost (10-16 Gy/5-8 fractions).
For mastectomy: chest wall irradiation (50 Gy/25 fractions).
No routine regional nodal irradiation unless pathologically positive.
Acute and late toxicities monitored per CTCAE v5.0.
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Radiotherapy delivered after R0 resection.
For breast-conserving surgery: whole-breast irradiation (50 Gy in 25 fractions, 2 Gy/fraction, 5 fractions/week) followed by sequential tumor bed boost (10-16 Gy in 5-8 fractions, 2 Gy/fraction).
For mastectomy: chest wall irradiation (50 Gy in 25 fractions).
Techniques allowed: IMRT, VMAT, or TOMO.
No routine regional nodal irradiation unless pathologically confirmed nodal involvement.
Target volume and organ-at-risk constraints as per protocol (e.g., ipsilateral lung Dmean <15 Gy, heart Dmean <5 Gy for left-sided tumors).
Acute and late toxicities assessed by CTCAE v5.0.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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2-year Local Recurrence-Free Survival (LRFS)
Periodo de tiempo: From randomization up to 2 years post-randomization (primary analysis at 2 years)
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Time from randomization to the first documented locoregional recurrence (ipsilateral breast/chest wall or regional lymph nodes) confirmed by imaging and/or pathology, or death from any cause, whichever occurs first.
Patients alive without locoregional recurrence are censored at the date of last known follow-up.
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From randomization up to 2 years post-randomization (primary analysis at 2 years)
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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Distant Metastasis-Free Survival (DMFS)
Periodo de tiempo: From randomization up to 5 years (primary analysis for secondary endpoints will be performed at 2 years, with extended follow-up up to 5 years)
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From randomization up to 5 years (primary analysis for secondary endpoints will be performed at 2 years, with extended follow-up up to 5 years)
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Disease-Free Survival (DFS)
Periodo de tiempo: From randomization up to 5 years (primary analysis of secondary endpoints at 2 years, with extended follow-up to 5 years)
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From randomization up to 5 years (primary analysis of secondary endpoints at 2 years, with extended follow-up to 5 years)
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Overall Survival (OS)
Periodo de tiempo: From randomization up to 5 years
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From randomization up to 5 years
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Incidence of Acute and Late Radiotherapy-Related Toxicities
Periodo de tiempo: From start of radiotherapy up to 5 years post-randomization (acute: within 90 days; late: from 90 days to 5 years)
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Proportion of patients experiencing adverse events (AEs) assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
Acute toxicity is defined as events occurring within 90 days after start of radiotherapy; late toxicity as events occurring >90 days after start of radiotherapy.
Includes radiation dermatitis, radiation pneumonitis, cardiac toxicity, rib fracture, breast/chest wall fibrosis, and secondary malignancies.
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From start of radiotherapy up to 5 years post-randomization (acute: within 90 days; late: from 90 days to 5 years)
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Publicaciones y enlaces útiles
Publicaciones Generales
- Zheng WH, Long ZQ, Kou J, Sun JY, Li FY, Zhang LL, He ZY. Postoperative radiation therapy in localized breast malignant phyllodes tumors: RPA-derived risk model identifies high-benefit subgroups with local control improvement. Breast. 2025 Dec;84:104617. doi: 10.1016/j.breast.2025.104617. Epub 2025 Oct 22.
- Kim YJ, Kim K. Radiation therapy for malignant phyllodes tumor of the breast: An analysis of SEER data. Breast. 2017 Apr;32:26-32. doi: 10.1016/j.breast.2016.12.006. Epub 2016 Dec 22.
- Ma B, Li X, Zhuang Z, Han M, Zhang Y, Ye F, Bi Z, Deng W, Zhang J, Yang Y, Nie Y. Effects of radiotherapy in borderline and malignant phyllodes tumors after R0 resection: a propensity score analysis. Ther Adv Med Oncol. 2025 Oct 27;17:17588359251387556. doi: 10.1177/17588359251387556. eCollection 2025.
- Varghese SS, Sasidharan B, Manipadam MT, Paul MJ, Backianathan S. Radiotherapy in Phyllodes Tumour. J Clin Diagn Res. 2017 Jan;11(1):XC01-XC03. doi: 10.7860/JCDR/2017/24591.9167. Epub 2017 Jan 1.
- Zhao W, Tian Q, Zhao A, Wang B, Yang J, Wang L, Zhang L, Dong D, Chen L, Yang J. The role of adjuvant radiotherapy in patients with malignant phyllodes tumor of the breast: a propensity-score matching analysis. Breast Cancer. 2021 Jan;28(1):110-118. doi: 10.1007/s12282-020-01135-7. Epub 2020 Aug 3.
- Barth RJ Jr, Wells WA, Mitchell SE, Cole BF. A prospective, multi-institutional study of adjuvant radiotherapy after resection of malignant phyllodes tumors. Ann Surg Oncol. 2009 Aug;16(8):2288-94. doi: 10.1245/s10434-009-0489-2. Epub 2009 May 8.
- Donato AR, Goncalves R, Maesaka JY, Aguiar FN, Soares JM Jr, Ruiz CA, Filassi JR, Baracat EC. Phyllodes tumors of the breast: A comprehensive review of diagnosis, treatment, and follow-up. Clinics (Sao Paulo). 2025 Mar 14;80:100617. doi: 10.1016/j.clinsp.2025.100617. eCollection 2025.
- Zhang H, Tang S, Biskup E, Zhang Y, Yong L, Chen L, Cai F. Long-term Survival After Diverse Therapeutic Modalities in Malignant Phyllodes Tumors of the Breast. Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221121086. doi: 10.1177/15330338221121086.
- Gradishar WJ, Moran MS, Abraham J, Abramson V, Aft R, Agnese D, Allison KH, Anderson B, Bailey J, Burstein HJ, Chen N, Chew H, Dang C, Elias AD, Giordano SH, Goetz MP, Jankowitz RC, Javid SH, Krishnamurthy J, Leitch AM, Lyons J, McCloskey S, McShane M, Mortimer J, Patel SA, Rosenberger LH, Rugo HS, Santa-Maria C, Schneider BP, Smith ML, Soliman H, Stringer-Reasor EM, Telli ML, Wei M, Wisinski KB, Yeung KT, Young JS, Schonfeld R, Kumar R. Breast Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2024 Jul;22(5):331-357. doi: 10.6004/jnccn.2024.0035.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
Otros números de identificación del estudio
- SYSKY-2026-390-02
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Información sobre medicamentos y dispositivos, documentos del estudio
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