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- Klinische proef NCT01646346
4D Image-Guided Partial Breast Radiation in Stage 0 and l Breast Cancer
25 oktober 2018 bijgewerkt door: Yale University
A Pilot Study of Four-Dimensional Conformal Image Guided Accelerated Partial Breast Irradiation In The Treatment Of Stage 0 and l Breast Cancer
The Purpose of this study is to evaluate the feasibility of using image guidance and four-dimensional computed tomography to reduce the volume of non target breast tissue that is treated with accelerated partial breast irradiation via the external beam technique.
Studie Overzicht
Toestand
Voltooid
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
This is a pilot study enrolling about 30 patients to evaluate the feasibility of using 4D CT and daily image guidance in Accelerated Partial Breast Irradiation (APBI) to decrease set-up error and individualized planning target volumes to limit the non-target breast tissue dose.
The two specific breasts constraints which shall be decreased are the V50 (percent volume of breast receiving 50% of the prescribed dose) and the V100 (percent volume of breast receiving 100% of the prescribed dose).
The goal will be to decrease these to 45% and 23.5% respectively, which is down 33% from the NSABP B39 standard of 60% and 35%.
Studietype
Ingrijpend
Inschrijving (Werkelijk)
46
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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Connecticut
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New Haven, Connecticut, Verenigde Staten, 06510
- Smilow Cancer Hospital Care Center, Yale New Haven Hospital
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
50 jaar en ouder (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Vrouw
Beschrijving
Inclusion Criteria:
- The patient must consent to be in the study and must have a signed an approved consent form conforming with institutional guidelines.
- Patient must be > 50 years old.
- The patient should have a life expectancy of at least two years with a karnofsky performance status > 70.
- The patient must have stage 0 or I breast cancer.
- On histological examination, the tumor must be DCIS or invasive adenocarcinoma of the breast.
- Surgical treatment of the breast must have been lumpectomy. The margins of the resected specimen must be histologically free of tumor (>2mm, DCIS and invasive). Re-excision of surgical margins is permitted.
- Gross disease must be unifocal with pathologic (invasive and/or DCIS) tumor size 2 cm or less. (Patients with microscopic multifocality are eligible as long as total pathologic tumor size is 2 cm or less.)
- Patients with invasive breast cancer are required to have axillary staging which can include sentinel node biopsy alone (if negative), sentinel node biopsy followed by axillary dissection or sampling with a minimum total of 6 axillary nodes or axillary dissection alone (with a minimum of 6 axillary nodes). Axillary staging is NOT required for patients with DCIS.
- The patient must have simulation within 8 weeks/56 days of the final surgery for their breast cancer (lumpectomy, re-excision of margins, or axillary staging procedure).
- Patients with a history of non-ipsilateral breast malignancies are eligible if they have been disease-free for 2 or more years prior to enrollment. Patients with the following cancers are eligible even if diagnosed and treated within the past 2 years: carcinoma in situ of the cervix, colon, melanoma in situ, and basal cell and squamous cell carcinoma of the skin.
- Chemotherapy is permitted if planned for ≥ 2 weeks after radiation.
- Urine pregnancy test must be performed and be negative on all women younger than 60 who have not had a tubal ligation, oophorectomy, or hysterectomy.
- Separate incisions for the lumpectomy and sentinel node biopsy should be present. Use of only one incision will typically result in a contiguous cavity with the tumor bed and the sentinel node sampling, and inability of the radiation oncologist to delineate the tumor bed from the sentinel node bed.
- The patient must have a cavity which is able to be targeted with external beam APBI, either through surgical clip placement, or CVS 3 or higher. The cavity to whole breast ratio must be 30% or less.
Exclusion Criteria:
- Men are not eligible for this study as men are not breast conservation candidates.
- T0, T2 (> 2.0 cm), T3, node positive, stage III or IV breast cancer.
- Any positive axillary nodes.
- Palpable or radiographically suspicious ipsilateral or contralateral axillary, supraclavicular, infraclavicular or internal mammary nodes, unless biopsy proven to be negative for tumor.
- Suspicious microcalcifications, densities or palpable abnormalities in either breast unless biopsy proven to be benign.
- Non-epithelial breast malignancies such as sarcoma or lymphoma.
- Proven multicentric carcinoma in more than one quadrant or separated by more than 2 centimeters.
- Paget's disease of the nipple.
- History of invasive breast cancer or DCIS in the same breast.
- Surgical margins that cannot be microscopically assessed or are less then 2 mm.
- Collagen vascular disease, specifically dermatomyositis with a CPK level above normal or with an active skin rash, systemic lupus erythematosis or scleroderma.
- Pregnancy or lactation at the time of proposed radiation. Women of reproductive potential must agree to use an effective non-hormonal method of contraception during therapy.
- Psychiatric or addictive disorders or other conditions that, in the opinion of the treating physician, would preclude the patient from meeting the study requirements.
- Patients with coexisting medical conditions in whom life expectancy is < 2 years.
- Patients with skin involvement, regardless of tumor size.
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
---|---|
Experimenteel: 4D Conformal Image-Guided Partial Breast RT
This is a single arm trial designed to look at the results in women treated with partial breast irradiation twice daily for 5 days.
|
External beam partial breast radiation to target a portion of the breast twice a day for 5 days.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
Patients With Reduction in Incidental Radiation
Tijdsspanne: 5 day
|
Patients were assessed to determine if there was a reduction in breast radiation V50 less than 45% and V100 less than 23.5%.
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5 day
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
Cosmesis by Patient Report
Tijdsspanne: Within no more than 8 weeks of surgery, but prior to the start of radiation
|
This outcome is measured by the Breast Cancer Treatment outcome Scale (BCTOS).
Eleven items (e.g., breast size, breast pain, breast shape) are rated by patients on a 4-point scale (0=no difference to 3=large difference), with a score range of 0-33 (higher scores signifying worse outcome).
Scores on each item are summed to obtain a total score.
|
Within no more than 8 weeks of surgery, but prior to the start of radiation
|
Cosmesis by Patient Report
Tijdsspanne: 1 year post treatment
|
This outcome is measured by the Breast Cancer Treatment outcome Scale (BCTOS).
Eleven items (e.g., breast size, breast pain, breast shape) are rated by patients on a 4-point scale (0=no difference to 3=large difference), with a score range of 0-33 (higher scores signifying worse outcome).
Scores on each item are summed to obtain a total score.
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1 year post treatment
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Cosmesis by Patient Report
Tijdsspanne: 3 year post treatment
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This outcome is measured by the Breast Cancer Treatment outcome Scale (BCTOS).
Eleven items (e.g., breast size, breast pain, breast shape) are rated by patients on a 4-point scale (0=no difference to 3=large difference), with a score range of 0-33 (higher scores signifying worse outcome).
Scores on each item are summed to obtain a total score.
|
3 year post treatment
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Cosmesis by Medical Doctor Report
Tijdsspanne: Within no more than 8 weeks of surgery, but prior to the start of radiation
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Medical doctor will be provided with cosmesis scale and grade cosmesis of breast.
Cosmesis was based on the Harvard Cosmesis Scale rated as :1.
excellent: the treated breast looked essentially the same as the opposite breast; 2. good: minimal but identifiable effects of radiation on the treated breast; 3. fair: significant effects of radiation on the breast were noted; 4. severe normal tissue sequelae.
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Within no more than 8 weeks of surgery, but prior to the start of radiation
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Cosmesis by Medical Doctor Report
Tijdsspanne: 1 yr post treatment
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Medical doctor will be provided with cosmesis scale and grade cosmesis of breast.
Cosmesis was based on the Harvard Cosmesis Scale rated as :1.
excellent: the treated breast looked essentially the same as the opposite breast; 2. good: minimal but identifiable effects of radiation on the treated breast; 3. fair: significant effects of radiation on the breast were noted; 4. severe normal tissue sequelae.
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1 yr post treatment
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Cosmesis by Medical Doctor Report
Tijdsspanne: 3 yr post treatment
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Medical doctor will be provided with cosmesis scale and grade cosmesis of breast.
Cosmesis was based on the Harvard Cosmesis Scale rated as :1.
excellent: the treated breast looked essentially the same as the opposite breast; 2. good: minimal but identifiable effects of radiation on the treated breast; 3. fair: significant effects of radiation on the breast were noted; 4. severe normal tissue sequelae.
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3 yr post treatment
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Onderzoekers
- Hoofdonderzoeker: Suzanne Evans, MD, Yale University
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Werkelijk)
10 januari 2012
Primaire voltooiing (Werkelijk)
17 juli 2017
Studie voltooiing (Werkelijk)
17 juli 2017
Studieregistratiedata
Eerst ingediend
11 maart 2012
Eerst ingediend dat voldeed aan de QC-criteria
18 juli 2012
Eerst geplaatst (Schatting)
20 juli 2012
Updates van studierecords
Laatste update geplaatst (Werkelijk)
23 november 2018
Laatste update ingediend die voldeed aan QC-criteria
25 oktober 2018
Laatst geverifieerd
1 oktober 2018
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 1110009173
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .
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