Carbon-Fibre Accessory (CARA) for Supine Breast Positioning to Reduce Toxicity in Whole Breast Radiotherapy

NCT ID: NCT04257396

Last Updated: 2023-01-25

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

220 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-11

Study Completion Date

2024-12-31

Brief Summary

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This trial is designed to assess the efficacy of a novel carbon-fibre adjustable reusable accessory (CARA) for breast support to reduce skin toxicity and unwanted normal tissue dose in comparison to the current clinical standard for supine breast support during whole breast RT.

Detailed Description

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This study is designed to assess the effectiveness of utilizing the CARA positioning device for reducing the incidence and severity of acute skin reactions in the infra-mammary fold in patients undergoing WBRT. Secondary outcomes include patient reported outcomes and dose to normal body tissue and organs at risk. This is a randomized controlled trial. Participants will be randomly assigned to the following two arms:

Arm 1 patients will receive CARA breast support. The known benefits to using CARA for breast positioning are reduction in IMF skin folds during treatment, reduction in breast separation, and reduction in V50% body, V105% body and lung V20 Gy in treatment planning. No known risks to using CARA have been identified.

Arm 2 patients will not receive CARA breast support. Patients in arm 2 may be treated with no breast support, a small foam wedge, a thermoplastic shell or alternate supine breast support method according to the current standard of care at the treating centre. These methods have entered RT clinical practice over decades of practice without published evidence of impact on rates of MD. Published rates of MD for the control arm thus pertain to a cross section of these methods. The control arm of this study will look at all of these methods combined. There may be centre specific preference for the control method and stratification by centre will be done.

Conditions

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Adjuvant Radiotherapy for Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Outcome Assessors
Skin assessments carried out by blinded observers

Study Groups

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Arm 1 CARA Positioning

Arm 1 patients will receive CARA breast support. The known benefits to using CARA for breast positioning are reduction in IMF skin folds during treatment, reduction in breast separation, and reduction in V50% body, V105% body and lung V20 Gy in treatment planning. No known risks to using CARA have been identified.

Group Type EXPERIMENTAL

Carbon-Fibre Adjustable Reuseable Accessory (CARA)

Intervention Type DEVICE

Breast support device having a carbon-fibre breast cradle for supine patient positioning.

Arm 2 Standard of Care

Arm 2 patients will not receive CARA breast support. Patients in arm 2 may be treated with no breast support, a small foam wedge, a thermoplastic shell or alternate supine breast support method according to the current standard of care at the treating centre. These methods have entered RT clinical practice over decades of practice without published evidence of impact on rates of MD. Published rates of MD for the control arm thus pertain to a cross section of these methods. The control arm of this study will look at all of these methods combined. There may be centre specific preference for the control method and stratification by centre will be done.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Carbon-Fibre Adjustable Reuseable Accessory (CARA)

Breast support device having a carbon-fibre breast cradle for supine patient positioning.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age 18 or older.
* Able to provide informed consent
* ECOG performance status 0 - 2
* Stage 0-3 invasive breast cancer or DCIS scheduled to received adjuvant radiotherapy to the whole breast
* Any infra-mammary skin fold of \>= 0.5 cm in the supine treatment position and/or palpable lateral breast tissue falling posterior to the mid-axilla line while in supine or treatment position.

Exclusion Criteria

* Inability to give informed consent or comply with experimental arm of trial
* Previous RT to either breast or to the chest
* Planned boost to infra mammary area
* Use of Mepitel while on treatment
* Failure to heal surgical wound or significant post-operative wound infection
* Presence of significant connective tissue disease (e.g. systemic sclerosis, SLE)
* Known radiation hypersensitivity phenotype (e.g. ataxia telangiectasia etc.)
* Breast reconstruction
* Planned partial breast irradiation, unless the treated area includes the infra-mammary fold
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Canadian Cancer Society (CCS)

OTHER

Sponsor Role collaborator

British Columbia Cancer Agency

OTHER

Sponsor Role lead

Responsible Party

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Cheryl Duzenli

Medical Physicist

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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BC Cancer

Prince George, British Columbia, Canada

Site Status RECRUITING

BC Cancer

Surrey, British Columbia, Canada

Site Status RECRUITING

BC Cancer

Vancouver, British Columbia, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Cheryl Duzenli, PhD

Role: CONTACT

604877-6000 ext. 2021

Facility Contacts

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Robert Olson, MD

Role: primary

Susan Balkwill, MD

Role: primary

Cheryl Duzenli, PhD

Role: primary

604877-6000 ext. 2021

References

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Malhotra A, Chan EK, Nichol A, Duzenli C. Spatial dose-distribution-based risk mapping to predict moist desquamation in breast radiotherapy. Phys Med Biol. 2025 May 27;70(11). doi: 10.1088/1361-6560/add985.

Reference Type DERIVED
PMID: 40373801 (View on PubMed)

Duzenli C, Chan EK, Bergman AM, Grahame S, Singer J, Burns L, Olson RA. A novel carbon-fibre adjustable reusable accessory (CARA) for supine breast positioning to reduce toxicity in breast adjuvant radiotherapy: a study protocol for a multicentre phase III randomized controlled trial. BMC Cancer. 2022 Jun 20;22(1):673. doi: 10.1186/s12885-022-09759-y.

Reference Type DERIVED
PMID: 35725457 (View on PubMed)

Other Identifiers

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H19-03343

Identifier Type: -

Identifier Source: org_study_id

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