Radiation Therapy in Treating Women With Locally Recurrent Breast Cancer Previously Treated With Repeat Breast-Preserving Surgery

NCT ID: NCT01082211

Last Updated: 2022-06-21

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

65 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-06-30

Study Completion Date

2022-05-20

Brief Summary

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RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Giving radiation therapy after surgery kill any remaining tumor cells and may be an effective treatment for breast cancer.

PURPOSE: This phase II trial is studying how well radiation therapy works in treating women with locally recurrent breast cancer previously treated with repeat breast-conserving surgery.

Detailed Description

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OBJECTIVES:

Primary

* To evaluate skin, breast, and chest wall adverse events occurring within 1 year after completion of 3D-conformal partial-breast re-irradiation following repeat breast-preserving surgery in patients with locally recurrent breast carcinoma.

Secondary

* To evaluate the adverse events occurring after 1 year from the completion of re-irradiation and at any time.
* To evaluate in-breast control rate in patients treated with this regimen.
* To evaluate freedom-from-mastectomy rate in these patients.
* To evaluate the rate of circulating tumor cells (CTCs) in this patient population and to document eradication of CTCs by locoregional therapy.
* To determine whether translational objective will correlate with eradication or presence of CTCs with in-breast recurrence and distant metastasis-free survival.
* To evaluate cosmesis as judged by the patient and independent evaluation.
* To evaluate distant metastasis-free survival, mastectomy-free survival, and overall survival of patients treated with this regimen.

OUTLINE: This is a multicenter study.

Patients undergo 3-dimensional conformal accelerated partial-breast irradiation twice daily, 5 days a week, for 3 weeks.

Some patients undergo blood sample collection at baseline and within 3 weeks after completion of radiotherapy for circulating tumor cells analysis.

Some patients complete questionnaires on cosmesis at baseline and at 1 and 3 years following radiotherapy.

After completion of study therapy, patients are followed up periodically for 4-5 years and then every year thereafter.

Conditions

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Breast Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Partial Breast Re-Irradiation

Partial Breast Re-Irradiation (PBrI) 3D-Conformal External Beam 1.5 Gy x 15 (BID) to 45 Gy Total

Group Type EXPERIMENTAL

3D-Conformal External Beam

Intervention Type RADIATION

Radiation was to be delivered in 2 fractions per day, each of 1.5 Gy, separated by at least six hours, given in 15 consecutive working days to a total of 30 fractions and 45 Gy. Radiation was to be prescribed to the treatment unit isocenter, positioned at the approximate center of the planning target volume.

Interventions

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3D-Conformal External Beam

Radiation was to be delivered in 2 fractions per day, each of 1.5 Gy, separated by at least six hours, given in 15 consecutive working days to a total of 30 fractions and 45 Gy. Radiation was to be prescribed to the treatment unit isocenter, positioned at the approximate center of the planning target volume.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Patients with a positive SLN biopsy require an axillary lymph node (ALN) dissection (ALND is not required if the SLN is not identified)
* Patient is eligible if 0-3 positive ALNs without extracapsular extension is documented
* If the in-breast recurrence is invasive disease and:

* No prior ALN dissection or SLN dissection only:

* Patient is required to undergo axillary evaluation with either a SLN or ALN dissection
* If the SLN is not identified or if the SLN is positive for metastatic disease then an ALN dissection is required
* Patient is eligible for enrollment if encounter 0-3 positive lymph nodes without extracapsular extension
* • Prior ALN dissection: negative clinical exam: patient is eligible for enrollment

* It is recommended, but not required, that the patient undergo ultrasound evaluation of the axilla and the lymph node draining regions of the breast; any suspicious areas are to be biopsied and if positive followed with an ALN dissection
* Patient is eligible for enrollment if biopsies are negative or 0-3 axillary lymph nodes without extracapsular extension are encountered
* Prior ALN dissection: positive clinical exam: biopsy required

* If biopsy is negative, patient is eligible for enrollment
* If biopsy is positive an ALN dissection is required
* Patient is eligible for enrollment if biopsies are negative or 0-3 axillary lymph nodes without extracapsular extension encountered
* Ipsilateral breast mammogram and MRI within 120 days prior to study entry
* Contralateral breast mammogram within 12 months of study entry
* For invasive in-breast recurrence, no more than 120 days since whole-body (positron emission tomography) PET-CT scan OR CT scan of the chest, abdomen, and pelvis, and bone scan
* No multicentric ipsilateral breast recurrence or regional recurrence (other than axilla)
* Patients must have a breast technically amenable to partial-breast irradiation
* No metastatic disease documented by physical exam or radiographic evaluation (for patients with invasive disease)
* No skin involvement
* No prior contralateral mastectomy
* Estrogen and progesterone status must be known

PATIENT CHARACTERISTICS:

* Zubrod performance status 0-1
* Menopausal status not specified
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No other invasive malignancy within the past 3 years except ipsilateral breast cancer and/or nonmelanoma skin cancer
* No collagenous diseases, specifically systemic lupus erythematosus, scleroderma, or dermatomyositis
* No psychiatric or addictive disorders that would preclude obtaining informed consent

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* More than 2 weeks since prior chemotherapy and recovered
* No concurrent intensity-modulated radiotherapy
* No concurrent chemotherapeutic agents, including trastuzumab
Minimum Eligible Age

18 Years

Maximum Eligible Age

120 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

NRG Oncology

OTHER

Sponsor Role collaborator

Radiation Therapy Oncology Group

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Douglas W. Arthur, MD

Role: PRINCIPAL_INVESTIGATOR

Massey Cancer Center

Locations

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Arizona Center for Cancer Care - Peoria

Peoria, Arizona, United States

Site Status

Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center

Burbank, California, United States

Site Status

University of Colorado Cancer Center at UC Health Sciences Center

Aurora, Colorado, United States

Site Status

JFK Medical Center

Atlantis, Florida, United States

Site Status

Robert H. Lurie Comprehensive Cancer Center at Northwestern University

Chicago, Illinois, United States

Site Status

Cancer Institute at St. John's Hospital

Springfield, Illinois, United States

Site Status

Greenebaum Cancer Center at University of Maryland Medical Center

Baltimore, Maryland, United States

Site Status

St. Agnes Hospital Cancer Center

Baltimore, Maryland, United States

Site Status

Central Maryland Oncology Center

Columbia, Maryland, United States

Site Status

Tate Cancer Center at Baltimore Washington Medical Center

Glen Burnie, Maryland, United States

Site Status

Cape Cod Hospital

Hyannis, Massachusetts, United States

Site Status

Saint Joseph Mercy Cancer Center

Ann Arbor, Michigan, United States

Site Status

University of Michigan Comprehensive Cancer Center

Ann Arbor, Michigan, United States

Site Status

Battle Creek Health System Cancer Care Center

Battle Creek, Michigan, United States

Site Status

McLaren Cancer Institute

Flint, Michigan, United States

Site Status

Butterworth Hospital at Spectrum Health

Grand Rapids, Michigan, United States

Site Status

Lacks Cancer Center at Saint Mary's Health Care

Grand Rapids, Michigan, United States

Site Status

Van Elslander Cancer Center at St. John Hospital and Medical Center

Grosse Pointe Woods, Michigan, United States

Site Status

West Michigan Cancer Center

Kalamazoo, Michigan, United States

Site Status

William Beaumont Hospital - Royal Oak Campus

Royal Oak, Michigan, United States

Site Status

Seton Cancer Institute at Saint Mary's - Saginaw

Saginaw, Michigan, United States

Site Status

Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis

St Louis, Missouri, United States

Site Status

Barnes-Jewish West County Hospital

St Louis, Missouri, United States

Site Status

Memorial Sloan-Kettering Cancer Center - Basking Ridge

Basking Ridge, New Jersey, United States

Site Status

St. Barnabas Medical Center Cancer Center

Livingston, New Jersey, United States

Site Status

Monmouth Medical Center

Long Branch, New Jersey, United States

Site Status

Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton

Marlton, New Jersey, United States

Site Status

Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School

New Brunswick, New Jersey, United States

Site Status

Cancer Institute of New Jersey at Cooper - Voorhees

Voorhees Township, New Jersey, United States

Site Status

Sands Cancer Center

Canandaigua, New York, United States

Site Status

Memorial Sloan-Kettering Cancer Center

Commack, New York, United States

Site Status

Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center

New York, New York, United States

Site Status

Highland Hospital of Rochester

Rochester, New York, United States

Site Status

University Radiation Oncology at Parkridge Hospital

Rochester, New York, United States

Site Status

James P. Wilmot Cancer Center at University of Rochester Medical Center

Rochester, New York, United States

Site Status

Memorial Sloan-Kettering Cancer Center - Rockville Centre

Rockville Centre, New York, United States

Site Status

Memorial Sloan-Kettering Cancer Center at Phelps Memorial Hospital Center

Sleepy Hollow, New York, United States

Site Status

Wake Forest University Comprehensive Cancer Center

Winston-Salem, North Carolina, United States

Site Status

McDowell Cancer Center at Akron General Medical Center

Akron, Ohio, United States

Site Status

Summa Center for Cancer Care at Akron City Hospital

Akron, Ohio, United States

Site Status

Barberton Citizens Hospital

Barberton, Ohio, United States

Site Status

Charles M. Barrett Cancer Center at University Hospital

Cincinnati, Ohio, United States

Site Status

Flower Hospital Cancer Center

Sylvania, Ohio, United States

Site Status

Rosenfeld Cancer Center at Abington Memorial Hospital

Abington, Pennsylvania, United States

Site Status

Delaware County Regional Cancer Center at Delaware County Memorial Hospital

Drexel Hill, Pennsylvania, United States

Site Status

Kimmel Cancer Center at Thomas Jefferson University - Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Fox Chase Cancer Center - Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Albert Einstein Cancer Center

Philadelphia, Pennsylvania, United States

Site Status

McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center

Reading, Pennsylvania, United States

Site Status

Rapid City Regional Hospital

Rapid City, South Dakota, United States

Site Status

Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas

Dallas, Texas, United States

Site Status

M. D. Anderson Cancer Center at University of Texas

Houston, Texas, United States

Site Status

Virginia Commonwealth University Massey Cancer Center

Richmond, Virginia, United States

Site Status

Community Memorial Hospital Cancer Care Center

Menomonee Falls, Wisconsin, United States

Site Status

Columbia Saint Mary's Hospital - Ozaukee

Mequon, Wisconsin, United States

Site Status

Columbia-Saint Mary's Cancer Care Center

Milwaukee, Wisconsin, United States

Site Status

Medical College of Wisconsin Cancer Center

Milwaukee, Wisconsin, United States

Site Status

Cross Cancer Institute at University of Alberta

Edmonton, Alberta, Canada

Site Status

Countries

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United States Canada

Other Identifiers

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CDR0000666991

Identifier Type: -

Identifier Source: secondary_id

RTOG 1014

Identifier Type: -

Identifier Source: org_study_id

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