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External-Beam Partial-Breast Irradiation for Early Breast Cancer 40 Gy QD Over 2 Weeks

12 oktober 2020 uppdaterad av: Alphonse Taghian, MD, PhD, Massachusetts General Hospital

A Phase I Study of Once-Daily External-Beam Partial-Breast Irradiation (PBI) for Selected Patients With Early Invasive N0 or Non-Invasive Breast Cancer

Standard therapy for patients with early stage breast cancer consists of surgery to remove the cancer followed by radiation therapy. One question regarding radiation therapy for early stage breast cancer is whether the entire breast needs to be radiated or only a more limited area surrounding the tumor. Whole-breast irradiation (WBI) is radiation therapy given to the whole breast. Partial-breast irradiation (PBI) is radiation therapy given only to the area of the breast where the cancer was removed (called the "tumor bed").

The investigators hope the option of PBI will reduce side effects from radiation therapy and shorten the radiation treatment process when compared to WBI, since only part of the breast is being treated. The investigators also hope that this will make such treatment more convenient for breast cancer patients.

The purpose of the study is to evaluate the the safety of external-beam PBI in selected early breast cancer patients utilizing PBI in ten daily fractions over two weeks. The investigators will also evaluate the local control and the cosmetic results.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

After signing the consent form, the following will be assessed.

-CT scan of the breast that had the cancer removed to help plan the radiation therapy. This is referred to as a CT-simulation. This scan is done routinely as part of the regular treatment.

PBI Study Treatment: You will be given PBI once daily over 10 treatment days (Mon-Fri) over a 2 week period. During this time you will have a weekly interview, physical examination, and your skin will be assessed for any side effects of the radiation.

PBI will begin between 4 weeks to 3 months after breast surgery or 2-6 weeks after chemotherapy (if you have been given chemotherapy).

After the final dose of the study:

You will have the following scheduled follow-up visits: one at the completion of the radiation, once or twice during weeks 3-9 after the completion of radiation, once every 6 months for five years, and then once every year for the following five years after the completion of radiation therapy.

Studietyp

Interventionell

Inskrivning (Faktisk)

54

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Förenta staterna
    • Massachusetts
      • Boston, Massachusetts, Förenta staterna, 02215
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Förenta staterna, 02215
        • Massachusetts General Hospital
      • Boston, Massachusetts, Förenta staterna, 02215
        • Beth Isreal Deaconness Medical Center
      • Boston, Massachusetts, Förenta staterna, 02215
        • Brigham and Women's Hosptial

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Kvinna

Beskrivning

Inclusion Criteria:

  • Unicentric Stage I invasive ductal breast cancer or Grade I or II DCIS measuring less than or equal to 2cm on pathology and/or mammography
  • Histologically negative tumor margin 2 mm or more from any inked edges, or no tumor in a re-excision specimen or final shaved specimen
  • Clips must be placed in the lumpectomy cavity at the time of final excision in order to aid in the delineation of the tumor cavity at the time of simulation and radiation delivery

Exclusion Criteria:

  • No distant metastasis
  • Not pregnant or breastfeeding
  • No diffuse suspicious microcalcifications
  • No prior radiation therapy to the ipsilateral or contralateral breast or thorax
  • No histologic evidence of lymphovascular invasion (LVI)
  • No histologic evidence of EIC
  • No history of cosmetic or reconstructive breast surgery
  • No psychiatric illness that would prevent the patient from giving informed consent
  • No medical conditions that, in the opinion of the treating physician would make this protocol unreasonably hazardous for the patient
  • No other currently active second malignancy other than non-melanoma skin cancers

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Partial Breast Irradiation
Partial Breast Irradiation using 40 Gy in 10 fractions over 2 weeks
Strålning: External Beam Partial-Breast Irradiation
40 Gy in ten daily fractions over two weeks

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Safety of External-beam PBI Utilizing 40Gy in Ten Daily Fractions Over Two Weeks
Tidsram: 2 years

The safety of external-beam PBI in selected stages 0 and I female breast cancer patients utilizing 40 Gy in ten daily fractions over two weeks. The study will be deemed too toxic if >10% of enrolled patients have at least one of the following outcomes within 24 months of completion of PBI.

  1. Grade 3 or 4 skin/subcutaneous or pulmonary toxicity.
  2. The development of clinical fat necrosis.
  3. The development of rib fracture on the ipsilateral treated side, detected either clinically and/or radiographically.

The data is shown as the number of participants that experienced each of the specific toxicities.
2 years

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Local Control Rates
Tidsram: 2 years
The local control rates (analyzed separately for patients with DCIS and invasive cancer). Local control is defined as lack of recurrence in the treated breast and ipsilateral axillary, supraclavicular and internal mammary lymph nodes. Recurrence is defined as the regrowth of tumor cells left following initial therapy and/or the development of new primary tumors unrelated to the original one. DCIS stands for 'Ductal Carcinoma In Situ'.
2 years
Distant Control Rates
Tidsram: 2 years
The number of participants that achieved distant control. Distant control is defined as a lack of distant metastasis following the completion of treatment. Distant metastasis refers to the development of disease at distant body sites like the lung, liver, bone, or brain.
2 years
Breast Cosmesis
Tidsram: End of treatment, 4-9 weeks post treatment, every six months for first 5 years, then annually for 5 years

Breast Cosmesis was assessed using a cosmetic scoring system. The data shown represent the latest assessment for each participant at the time of analysis. Cosmetic changes were assessed using the following the following criteria.

  • Excellent: Little or no observable change
  • Good: Minimal but identifiable changes
  • Fair: Significant results of radiotherapy noted
  • Poor: Severe normal tissue sequelae
End of treatment, 4-9 weeks post treatment, every six months for first 5 years, then annually for 5 years

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Massachusetts General Hospital

Samarbetspartners

Beth Israel Deaconess Medical Center
Brigham and Women's Hospital

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 maj 2012

Primärt slutförande (Faktisk)

1 augusti 2016

Avslutad studie (Faktisk)

1 augusti 2019

Studieregistreringsdatum

Först inskickad

11 januari 2012

Först inskickad som uppfyllde QC-kriterierna

18 april 2012

Första postat (Uppskatta)

20 april 2012

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

2 november 2020

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

12 oktober 2020

Senast verifierad

1 oktober 2020

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 11-351

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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