Randomized Study of Elective Regional Lymph Node Irradiation in N1 Breast Cancer

NCT ID: NCT03269981

Last Updated: 2023-11-27

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

827 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-04-01

Study Completion Date

2029-12-30

Brief Summary

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This study evaluates the impact of elective regional lymph node irradiation on N1 breast cancer patients receiving post-lumpectomy radiotherapy and anthracycline plus taxane (AT)-based chemotherapy. We randomly assign patients having one to three metastatic lymph nodes (pN1) after breast-conserving surgery (BCS) and AT-based chemotherapy to undergo either whole-breast and regional nodal irradiation (WB+RNI group) or whole-breast irradiation alone (WBI group).

Detailed Description

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Objective:

* Compare the effect of post-BCS WBI vs. WB+RNI on disease-free survival in pN1 breast cancer patients who received AT-based chemotherapy.
* Evaluate the impact of WBI or WB+RNI according to molecular subtype of tumor.
* Compare the treatment-related toxicities between the WBI and WB+RNI.
* Compare the patient's quality of life between the WBI and WB+RNI.

Outline: This is a a randomized, multi-center, phase III study. Patients are stratified according to molecular subtype of tumor (luminal A vs luminal vs luminal HER2 vs HER2-enriched vs basal-like), axillary lymph node management (sentinel lymph node biopsy \[SLN\] only vs axillary lymph node dissection+/- SLN) and participating institutions. Patients are randomized to one of two treatment arms.

* Arm I: Patients receive WB+RNI.
* Arm II: Patients receive WBI alone.

Arm circumference and quality of life (EORTC QLQ-C30 \& EORTC QLQ-BR23) are assessed within 2 weeks prior to randomization, during the last week of radiotherapy, at 3 months after completion of radiotherapy, and then annually thereafter for five years.

Patients are followed at 3 months after completion of radiotherapy and annually thereafter for seven years.

Conditions

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Breast Neoplasm

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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Whole breast irradiation

Post-lumpectomy radiotherapy to the whole breast alone.

Group Type EXPERIMENTAL

Whole breast irradiation

Intervention Type RADIATION

Radiotherapy to the whole breast alone.

Whole breast and nodal irradiation

Post-lumpectomy radiotherapy to the whole breast and regional lymph node.

Group Type ACTIVE_COMPARATOR

Whole breast and nodal irradiation

Intervention Type RADIATION

Radiotherapy to the whole breast and regional lymph nodes.

Interventions

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Whole breast irradiation

Radiotherapy to the whole breast alone.

Intervention Type RADIATION

Whole breast and nodal irradiation

Radiotherapy to the whole breast and regional lymph nodes.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Histologically proven invasive carcinoma of the breast.
* One to three positive axillary lymph nodes (pN1) proven in pathologic specimen.
* Prior breast-conserving surgery and post-operative adjuvant chemotherapy including taxane.
* Administering adjuvant hormonal therapy in cases with hormone receptor-positive tumor.
* Administering anti-HER2 therapy in cases with HER2-positive tumor.

Exclusion Criteria

* Metastases in supraclavicular or internal mammary lymph nodes.
* Metastases in distant organs.
* Neoadjuvant chemotherapy or hormone therapy before surgery.
* Not receiving adjuvant anthracycline and taxane.
* Bilateral breast cancer
* Previous history of radiotherapy of the ipsilateral breast or supraclavicular lymph nodes.
* Prior history of other types of cancer, except thyroid cancer, carcinoma in situ of the cervix, or skin cancer.
Minimum Eligible Age

20 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Korean Radiation Oncology Group

UNKNOWN

Sponsor Role collaborator

Ministry of Health, Republic of Korea

OTHER_GOV

Sponsor Role collaborator

Samsung Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Won Park, MD

Role: STUDY_CHAIR

Samsung Medical Center

Locations

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Samsung Medical Center

Seoul, , South Korea

Site Status

Countries

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South Korea

Other Identifiers

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SMC 2017-01-085-001

Identifier Type: -

Identifier Source: org_study_id