Effects of Radiotherapy in Borderline and Malignant Phyllodes Tumors After R0 Resection

NCT ID: NCT06780059

Last Updated: 2025-01-17

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

Total Enrollment

480 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-12-30

Study Completion Date

2025-01-02

Brief Summary

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Breast phyllodes tumors (PT) are rare fibroepithelial neoplasms originating from stromal tissue and account for less than 1% of all breast tumors. The World Health Organization (WHO) classifies PT into benign, borderline, and malignant subtypes based on pathological features such as mitotic activity, cellular atypia, tumor margin invasion, and stromal composition 1. The presence of malignant heterologous elements characterizes the tumor as malignant 2. Surgery is the primary treatment. However, even after R0 resection, borderline phyllodes tumors (BoPT) and malignant phyllodes tumors (MPT) patients remain face a high risk of local recurrence, with rates of 15%-20% and 25%-30%, respectively. Moreover, metastases occur almost merely in MPT, with a distant metastasis rate reaching 22%.

Adjuvant radiotherapy has attracted attention for its potential to improve local control and reduce recurrence, but the role after R0 resection in PT patients remains unclear. Radiotherapy significantly reduces local recurrence rates in BoPT and MPT but shows no substantial benefit in benign cases. However, a meta-analysis by Yu et al. found that this effect is limited to MPT. Additionally, the effect of radiotherapy on survival rates in PT remains controversial. Most existing studies are retrospective and face limitations such as small sample sizes. The rarity of PT and conflicting evidence of impact of radiotherapy necessitate further study. While prospective trials are difficult due to limited cases, well-designed retrospective studies can offer valuable insights. In this study, the investigators also analyzed prognostic factors and identified subgroups to provide a clinical reference for the application of postoperative radiotherapy in BoPT and MPT patients.

Detailed Description

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Conditions

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Radiotherapy, Adjuvant Phyllodes Breast Tumor Prognosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Phyllodes tumors patients who received radiotherapy afte R0 resection

Adjuvant Radiotherapy

Intervention Type RADIATION

Postoperative Radiotherapy with 3D-CRT and IMRT Techniques Following R0 Resection in BoPT and MPT Patients

R0 resection

Intervention Type PROCEDURE

Patients who received R0 resection (complete resection without tumor margin)

Phyllodes tumors patients who received R0 resection alone

R0 resection

Intervention Type PROCEDURE

Patients who received R0 resection (complete resection without tumor margin)

Interventions

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Adjuvant Radiotherapy

Postoperative Radiotherapy with 3D-CRT and IMRT Techniques Following R0 Resection in BoPT and MPT Patients

Intervention Type RADIATION

R0 resection

Patients who received R0 resection (complete resection without tumor margin)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* patients who were initially diagnosed with BoPT or MPT and underwent R0 resection surgery

Exclusion Criteria

* patients who had their initial surgery at other hospitals without accurate baseline data
* patients who received radiotherapy before surgery
* those presenting with initial distant metastasis before treatment
* patients lost to follow-up after treatment
* patients with a history of or concurrent breast cancer or precancerous lesions in the ipsilateral breast or with breast cancer in the contralateral breast
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

OTHER

Sponsor Role lead

Responsible Party

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Yan Nie

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Sun Yat-sen University Cancer Center

Guangzhou, Guangdong, China

Site Status

Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University

Guangzhou, Guangdong, China

Site Status

Third Hospital of Nanchang

Nanchang, Jiangxi, China

Site Status

Countries

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China

References

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Macdonald OK, Lee CM, Tward JD, Chappel CD, Gaffney DK. Malignant phyllodes tumor of the female breast: association of primary therapy with cause-specific survival from the Surveillance, Epidemiology, and End Results (SEER) program. Cancer. 2006 Nov 1;107(9):2127-33. doi: 10.1002/cncr.22228.

Reference Type BACKGROUND
PMID: 16998937 (View on PubMed)

Pandey M, Mathew A, Kattoor J, Abraham EK, Mathew BS, Rajan B, Nair KM. Malignant phyllodes tumor. Breast J. 2001 Nov-Dec;7(6):411-6. doi: 10.1046/j.1524-4741.2001.07606.x.

Reference Type BACKGROUND
PMID: 11843853 (View on PubMed)

Boutrus RR, Khair S, Abdelazim Y, Nasr S, Ibraheem MH, Farahat A, El Sebaie M. Phyllodes tumors of the breast: Adjuvant radiation therapy revisited. Breast. 2021 Aug;58:1-5. doi: 10.1016/j.breast.2021.03.013. Epub 2021 Apr 7.

Reference Type BACKGROUND
PMID: 33865208 (View on PubMed)

Yu CY, Huang TW, Tam KW. Management of phyllodes tumor: A systematic review and meta-analysis of real-world evidence. Int J Surg. 2022 Nov;107:106969. doi: 10.1016/j.ijsu.2022.106969. Epub 2022 Oct 31.

Reference Type BACKGROUND
PMID: 36328344 (View on PubMed)

Li J, Tsang JY, Chen C, Chan SK, Cheung SY, Wu C, Kwong A, Hu J, Hu H, Zhou D, Tse GM. Predicting Outcome in Mammary Phyllodes Tumors: Relevance of Clinicopathological Features. Ann Surg Oncol. 2019 Sep;26(9):2747-2758. doi: 10.1245/s10434-019-07445-1. Epub 2019 May 20.

Reference Type BACKGROUND
PMID: 31111353 (View on PubMed)

Belkacemi Y, Bousquet G, Marsiglia H, Ray-Coquard I, Magne N, Malard Y, Lacroix M, Gutierrez C, Senkus E, Christie D, Drumea K, Lagneau E, Kadish SP, Scandolaro L, Azria D, Ozsahin M. Phyllodes tumor of the breast. Int J Radiat Oncol Biol Phys. 2008 Feb 1;70(2):492-500. doi: 10.1016/j.ijrobp.2007.06.059. Epub 2007 Oct 10.

Reference Type BACKGROUND
PMID: 17931796 (View on PubMed)

Pezner RD, Schultheiss TE, Paz IB. Malignant phyllodes tumor of the breast: local control rates with surgery alone. Int J Radiat Oncol Biol Phys. 2008 Jul 1;71(3):710-3. doi: 10.1016/j.ijrobp.2007.10.051. Epub 2008 Jan 30.

Reference Type BACKGROUND
PMID: 18234448 (View on PubMed)

Moffat CJ, Pinder SE, Dixon AR, Elston CW, Blamey RW, Ellis IO. Phyllodes tumours of the breast: a clinicopathological review of thirty-two cases. Histopathology. 1995 Sep;27(3):205-18. doi: 10.1111/j.1365-2559.1995.tb00212.x.

Reference Type BACKGROUND
PMID: 8522284 (View on PubMed)

Md Nasir ND, Koh VCY, Cree IA, Ruiz BII, Del Aguila J, Armon S, Fox SB, Lakhani SR, Tan PH. Phyllodes tumour evidence gaps mapped from the 5th edition of the WHO classification of tumours of the breast. Histopathology. 2023 Apr;82(5):704-712. doi: 10.1111/his.14856. Epub 2023 Jan 30.

Reference Type BACKGROUND
PMID: 36579383 (View on PubMed)

Other Identifiers

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SYSKY-2024-1127-01

Identifier Type: -

Identifier Source: org_study_id

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