Radiation Therapy After Surgery in Treating Women With Early Stage Breast Cancer

NCT ID: NCT00005587

Last Updated: 2013-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Study Classification

INTERVENTIONAL

Study Start Date

1999-01-31

Study Completion Date

2004-06-30

Brief Summary

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RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known which regimen of radiation therapy is more effective following surgery for breast cancer.

PURPOSE: Randomized phase III trial to compare the effectiveness of two regimens of radiation therapy following surgery in treating women who have early stage breast cancer.

Detailed Description

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OBJECTIVES:

* Determine the benefits of radiotherapy schedules using fraction sizes larger than 2.0 Gy in terms of normal tissue responses, local-regional tumor control, quality of life, and economic consequences in women prescribed postoperative radiotherapy for early stage breast cancer.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to center, type of surgery (mastectomy vs local excision), and breast boost (yes vs no). Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive radiotherapy 5 times a week for 5 weeks for a total dose of 50 Gy.
* Arm II: Patients receive radiotherapy 5 times a week for 3 weeks for a total dose of 40 Gy.

A breast boost is recommended in both arms for patients with microscopic evidence of invasive or in situ cancer at, or within 1 mm of, a resection margin. These patients receive radiotherapy for 5 fractions in 1 week for a total boost dose of 10 Gy.

Quality of life is assessed at baseline and then at 6, 12, 24, and 60 months.

Patients are followed annually for up to 20 years.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 1840 patients (920 per arm) will be accrued for this study.

Conditions

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Breast Cancer

Keywords

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stage I breast cancer stage II breast cancer stage IIIA breast cancer

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

TREATMENT

Interventions

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radiation therapy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed invasive unilateral breast cancer

* T1-3, N0-1, M0 at presentation
* Complete macroscopic excision of tumor by breast conserving surgery or mastectomy
* No immediate breast reconstruction
* No requirement for axillary radiotherapy after greater than a Level 1 axillary dissection or after greater than 10 lymph nodes have been removed
* Not enrolled on SECRAB or OSCAR trials
* Hormone receptor status:

* Not specified

PATIENT CHARACTERISTICS:

Age:

* 18 and over

Sex:

* Female

Menopausal status:

* Not specified

Performance status:

* Not specified

Life expectancy:

* Not specified

Hematopoietic:

* Not specified

Hepatic:

* Not specified

Renal:

* Not specified

PRIOR CONCURRENT THERAPY:

* Prior neoadjuvant, or primary medical, therapy is allowed provided subsequent surgery confirms complete macroscopic excision of residual primary tumor

Biologic therapy:

* Not specified

Chemotherapy:

* At least 2 weeks since prior cytotoxic agents
* No concurrent chemotherapy

Endocrine therapy:

* Not specified

Radiotherapy:

* See Disease Characteristics

Surgery:

* See Disease Characteristics
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Medical Research Council

OTHER_GOV

Sponsor Role lead

Principal Investigators

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John R. Yarnold, MD, FRCR

Role: STUDY_CHAIR

Royal Marsden NHS Foundation Trust

Locations

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Royal Sussex County Hospital

Brighton, England, United Kingdom

Site Status

Addenbrooke's NHS Trust

Cambridge, England, United Kingdom

Site Status

Cheltenham General Hospital

Cheltenham, England, United Kingdom

Site Status

Royal Devon and Exeter Hospital

Exeter, England, United Kingdom

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Royal Surrey County Hospital

Guildford, England, United Kingdom

Site Status

Ipswich Hospital NHS Trust

Ipswich, England, United Kingdom

Site Status

University Hospitals of Leicester

Leicester, England, United Kingdom

Site Status

Guy's and St. Thomas' Hospitals Trust

London, England, United Kingdom

Site Status

Maidstone Hospital

Maidstone, England, United Kingdom

Site Status

Christie Hospital N.H.S. Trust

Manchester, England, United Kingdom

Site Status

Clatterbridge Centre for Oncology NHS Trust

Merseyside, England, United Kingdom

Site Status

South Tees Hospitals NHS Trust

Middlesbrough, Cleveland, England, United Kingdom

Site Status

King Edward VII Hospital

Midhurst, England, United Kingdom

Site Status

Mount Vernon Hospital

Northwood, England, United Kingdom

Site Status

Norfolk & Norwich Hospital

Norwich, England, United Kingdom

Site Status

Nottingham City Hospital NHS Trust

Nottingham, England, United Kingdom

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Derriford Hospital

Plymouth, England, United Kingdom

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Royal Berkshire Hospital

Reading, England, United Kingdom

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Oldchurch Hospital

Romford, England, United Kingdom

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Weston Park Hospital

Sheffield, England, United Kingdom

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Royal Shrewsbury Hospital

Shrewsbury, England, United Kingdom

Site Status

North Staffs Royal Infirmary

Stoke-on-Trent, England, United Kingdom

Site Status

Royal Marsden Hospital

Sutton, England, United Kingdom

Site Status

Torbay Hospital

Torquay Devon, England, United Kingdom

Site Status

Southend NHS Trust Hospital

Westcliff-on-Sea, England, United Kingdom

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New Cross Hospital

Wolverhampton, England, United Kingdom

Site Status

Belfast City Hospital Trust Incorporating Belvoir Park Hospital

Belfast, Northern Ireland, United Kingdom

Site Status

Ninewells Hospital and Medical School

Dundee, Scotland, United Kingdom

Site Status

Velindre Hospital

Cardiff, Wales, United Kingdom

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Cumberland Infirmary

Carlisle, , United Kingdom

Site Status

Saint Mary's Hospital

Portsmouth Hants, , United Kingdom

Site Status

Royal Preston Hospital

Preston, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Hopwood P, Haviland JS, Sumo G, Mills J, Bliss JM, Yarnold JR; START Trial Management Group. Comparison of patient-reported breast, arm, and shoulder symptoms and body image after radiotherapy for early breast cancer: 5-year follow-up in the randomised Standardisation of Breast Radiotherapy (START) trials. Lancet Oncol. 2010 Mar;11(3):231-40. doi: 10.1016/S1470-2045(09)70382-1. Epub 2010 Feb 6.

Reference Type RESULT
PMID: 20138809 (View on PubMed)

START Trialists' Group; Bentzen SM, Agrawal RK, Aird EG, Barrett JM, Barrett-Lee PJ, Bentzen SM, Bliss JM, Brown J, Dewar JA, Dobbs HJ, Haviland JS, Hoskin PJ, Hopwood P, Lawton PA, Magee BJ, Mills J, Morgan DA, Owen JR, Simmons S, Sumo G, Sydenham MA, Venables K, Yarnold JR. The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet. 2008 Mar 29;371(9618):1098-107. doi: 10.1016/S0140-6736(08)60348-7. Epub 2008 Mar 19.

Reference Type RESULT
PMID: 18355913 (View on PubMed)

Hopwood P, Haviland J, Mills J, Sumo G, M Bliss J; START Trial Management Group. The impact of age and clinical factors on quality of life in early breast cancer: an analysis of 2208 women recruited to the UK START Trial (Standardisation of Breast Radiotherapy Trial). Breast. 2007 Jun;16(3):241-51. doi: 10.1016/j.breast.2006.11.003. Epub 2007 Jan 19.

Reference Type RESULT
PMID: 17236771 (View on PubMed)

Venables K, Miles EA, Aird EG, Hoskin PJ; START Trial Management Group. The use of in vivo thermoluminescent dosimeters in the quality assurance programme for the START breast fractionation trial. Radiother Oncol. 2004 Jun;71(3):303-10. doi: 10.1016/j.radonc.2004.02.008.

Reference Type RESULT
PMID: 15172146 (View on PubMed)

Other Identifiers

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STMG-STARTB

Identifier Type: -

Identifier Source: secondary_id

EU-99015

Identifier Type: -

Identifier Source: secondary_id

CDR0000067661

Identifier Type: -

Identifier Source: org_study_id