Outcome of 15 Versus 5 Fractions in Adjuvant Breast Radiotherapy in Women Over 65 Years

NCT ID: NCT03121248

Last Updated: 2023-12-22

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

144 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-15

Study Completion Date

2026-11-15

Brief Summary

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This study will evaluate the effect of highly accelerated external beam radiotherapy (EBRT) in 5 fractions over 10 days compared to 15 fractions over 3 weeks for early as well as locally-advanced stage breast cancer.

Primary endpoint will be chronic toxicity (breast deformation and retraction). Secondary endpoints are acute toxicity, loco-regional and distant tumor control, patient reported QoL and cosmetic satisfaction. Patients with lymph node irradiation will be closely monitored for radiation induced plexopathy.

Detailed Description

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Over the age of 65, uptake of adjuvant radiotherapy after surgery for breast cancer declines, even in women with poor prognostic stage or adverse tumor characteristics.

Lowering the number of fractions may reduce reluctancy for radiotherapy in this age group.

In a preceding prospective phase I-II trial, evaluating EBRT over 10 days, results on technical feasibility and acute toxicity were positively evaluated.

However, data on the chronic effects of breast irradiation using high doses per fraction are still sparse.

This trial is developed to compare standard hypo-fractionation in 15 fractions (if needed with simultaneously integrated boost - SIB) with highly accelerated radiotherapy in 5 fractions.

Patients referred for adjuvant radiotherapy after breast conserving surgery will preferably be randomized, depending on the indication, to a study-arm with whole breast irradiation (WBI) +/- SIB or to a study-arm with WBI+/- SIB and lymph node irradiation (LNI).

If patients after breast conserving surgery (BCS) have a strong preference for 5 or 15 fractions, they will be invited to enter the parallel observational arm (patient preference).

Patients referred for adjuvant radiotherapy after mastectomy +/- LNI accepting to participate, can choose a 5 or 15-fraction schedule. No randomization is foreseen in this last observational group.

Conditions

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Breastcancer

Keywords

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Accelerated radiotherapy Older women Hypo-fractonation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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WBI - randomized - 5

WBI 5 fractions SIB 5 fractions if needed

Group Type EXPERIMENTAL

WBI 5 fractions

Intervention Type RADIATION

External beam radiotherapy in 5 fractions of 5,7Gy

SIB 5 fractions if needed

Intervention Type RADIATION

Simultaneous boost of 5 x 6,2Gy (6,5Gy in case of involved resection margins) if needed

WBI - randomized - 15

WBI 15 fractions SIB 15 fractions if needed

Group Type ACTIVE_COMPARATOR

WBI 15 fractions

Intervention Type RADIATION

External beam radiotherapy in 15 fractions of 2,67Gy

SIB 15 fractions if needed

Intervention Type RADIATION

Simultaneous boost of 15x3,12Gy (3,33Gy in case of involved resection margins) if needed

WBI - observational - 5

WBI 5 fractions SIB 5 fractions if needed

Group Type EXPERIMENTAL

WBI 5 fractions

Intervention Type RADIATION

External beam radiotherapy in 5 fractions of 5,7Gy

SIB 5 fractions if needed

Intervention Type RADIATION

Simultaneous boost of 5 x 6,2Gy (6,5Gy in case of involved resection margins) if needed

WBI - observational - 15

WBI 15 fractions SIB 15 fractions if needed

Group Type ACTIVE_COMPARATOR

WBI 15 fractions

Intervention Type RADIATION

External beam radiotherapy in 15 fractions of 2,67Gy

SIB 15 fractions if needed

Intervention Type RADIATION

Simultaneous boost of 15x3,12Gy (3,33Gy in case of involved resection margins) if needed

WBI + LNI - randomized - 5

WBI 5 fractions SIB 5 fractions if needed LNI 5 fractions

Group Type EXPERIMENTAL

WBI 5 fractions

Intervention Type RADIATION

External beam radiotherapy in 5 fractions of 5,7Gy

LNI 5 fractions

Intervention Type RADIATION

External beam radiotherapy in 5 fractions of 5,4Gy

SIB 5 fractions if needed

Intervention Type RADIATION

Simultaneous boost of 5 x 6,2Gy (6,5Gy in case of involved resection margins) if needed

WBI + LNI - randomized - 15

WBI 15 fractions SIB 15 fractions if needed LNI 15 fractions

Group Type ACTIVE_COMPARATOR

WBI 15 fractions

Intervention Type RADIATION

External beam radiotherapy in 15 fractions of 2,67Gy

LNI 15 fractions

Intervention Type RADIATION

External beam radiotherapy in 15 fractions of 2,67Gy

SIB 15 fractions if needed

Intervention Type RADIATION

Simultaneous boost of 15x3,12Gy (3,33Gy in case of involved resection margins) if needed

WBI with LNI - observational - 5

WBI 5 fractions SIB 5 fractions if needed LNI 5 fractions

Group Type EXPERIMENTAL

WBI 5 fractions

Intervention Type RADIATION

External beam radiotherapy in 5 fractions of 5,7Gy

LNI 5 fractions

Intervention Type RADIATION

External beam radiotherapy in 5 fractions of 5,4Gy

SIB 5 fractions if needed

Intervention Type RADIATION

Simultaneous boost of 5 x 6,2Gy (6,5Gy in case of involved resection margins) if needed

WBI with LNI - observational - 15

WBI 15 fractions SIB 15 fractions if needed LNI 15 fractions

Group Type ACTIVE_COMPARATOR

WBI 15 fractions

Intervention Type RADIATION

External beam radiotherapy in 15 fractions of 2,67Gy

LNI 15 fractions

Intervention Type RADIATION

External beam radiotherapy in 15 fractions of 2,67Gy

SIB 15 fractions if needed

Intervention Type RADIATION

Simultaneous boost of 15x3,12Gy (3,33Gy in case of involved resection margins) if needed

thoracic wall irradiation (TWI) +/- LNI - observational - 5

TWI 5 fractions SIB 5 fractions if needed LNI 5 fractions

Group Type EXPERIMENTAL

LNI 5 fractions

Intervention Type RADIATION

External beam radiotherapy in 5 fractions of 5,4Gy

TWI 5 fractions

Intervention Type RADIATION

External beam radiotherapy in 5 fractions of 5,7Gy

TWI +/- LNI - observational - 15

TWI 15 fractions SIB 15 fractions if needed LNI 15 fractions

Group Type ACTIVE_COMPARATOR

LNI 15 fractions

Intervention Type RADIATION

External beam radiotherapy in 15 fractions of 2,67Gy

TWI 15 fractions

Intervention Type RADIATION

External beam radiotherapy in 15 fractions of 2,67Gy

Interventions

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WBI 5 fractions

External beam radiotherapy in 5 fractions of 5,7Gy

Intervention Type RADIATION

WBI 15 fractions

External beam radiotherapy in 15 fractions of 2,67Gy

Intervention Type RADIATION

LNI 5 fractions

External beam radiotherapy in 5 fractions of 5,4Gy

Intervention Type RADIATION

LNI 15 fractions

External beam radiotherapy in 15 fractions of 2,67Gy

Intervention Type RADIATION

SIB 5 fractions if needed

Simultaneous boost of 5 x 6,2Gy (6,5Gy in case of involved resection margins) if needed

Intervention Type RADIATION

SIB 15 fractions if needed

Simultaneous boost of 15x3,12Gy (3,33Gy in case of involved resection margins) if needed

Intervention Type RADIATION

TWI 5 fractions

External beam radiotherapy in 5 fractions of 5,7Gy

Intervention Type RADIATION

TWI 15 fractions

External beam radiotherapy in 15 fractions of 2,67Gy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* breast conserving surgery or mastectomy for breast carcinoma
* multidisciplinary decision of adjuvant irradiation
* absence of distant metastases
* informed consent obtained, signed and dated before specific protocol procedures

Exclusion Criteria

* History of previous radiation treatment to the same region
* Bilateral breast irradiation
* Life expectancy of less than 2 years
* Planned reconstructive breast surgery
* Condition making toxicity evaluation difficult, e.g. skin disorders, pre-existing brachial plexus injury, …
* Inability to respect constraints on skin, heart, lungs, esophagus, ribs, brachial plexus or any other organ at risk
* Mental condition rendering the patient unable to understand the nature, scope and possible consequences of the study
* Patient unlikely to comply with the protocol; i.e. uncooperative attitude, inability to return for follow-up visits or unlikely to complete the study
Minimum Eligible Age

65 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Ghent

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Liv Veldeman, M.D., PhD

Role: PRINCIPAL_INVESTIGATOR

Ghent University Hospital, Dept. Radiotherapy-Oncology

Locations

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Ghent University Hospital, Dept. Radiotherapy-Oncology

Ghent, , Belgium

Site Status

Countries

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Belgium

Related Links

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http://dx.doi.org/10.1016/j.ijrobp.2017.01.229

HAI-5 feasilibility trial: results acute toxicity

Other Identifiers

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EC/2016/1386

Identifier Type: -

Identifier Source: org_study_id