Ultra-hypofractionated Whole Breast Irradiation With Lumpectomy Cavity Boost for the Treatment of Stage I-III Breast Cancer

NCT ID: NCT06954831

Last Updated: 2025-10-29

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

82 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-28

Study Completion Date

2028-01-31

Brief Summary

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This clinical trial tests how well ultra-hypofractionated (UF) whole breast irradiation (WBI) with lumpectomy cavity boost (CB) works in treating patients with stage I-III breast cancer. Breast conservation therapy (BCT) is the recommended treatment for patients with early stage breast cancer. BCT involves a lumpectomy followed by breast radiation. Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill tumor cells and shrink tumors. Traditionally, WBI has been given once daily over 5-6 weeks and then those at high-risk for recurrence receive additional radiation (boost) to the lumpectomy cavity daily over 4-8 days. This has now been replaced by moderate hypofractionated radiation. Hypofractionated radiation therapy delivers higher doses of radiation therapy over a shorter period of time and may kill more tumor cells and have fewer side effects. Although moderate hypofractionated radiation therapy reduces the length of treatment from 6-7 weeks to 3-4 weeks, the length of treatment still remains a barrier for many patients. UF-WBI with CB delivers radiation to the whole breast and the surgical cavity at the same time over 5 daily treatments. Giving UF-WBI with CB may prevent recurrence and prolong survival as well as improve the quality of life in patients with stage I-III breast cancer.

Detailed Description

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PRIMARY OBJECTIVE:

I. To evaluate the impact of UF-WBI + CB as assessed by patient-reported Global Cosmesis Score (GCS) at 1 year.

SECONDARY OBJECTIVES:

I. To characterize the patient-reported cosmetic appearance of the breast over time, as assessed by GCS.

II. To determine short- and long-term physician-reported cosmetic appearance of the breast, as assessed by GCS.

III. To evaluate the acute and late patient-reported radiation-associated toxicities.

IV. To evaluate the acute and late physician-reported radiation-associated toxicities.

V. To estimate:

Va. 5-year in-breast recurrence; Vb. 5-year distant recurrence; Vc. 5-year disease-free survival (DFS); Vd. 5-year overall survival (OS).

EXPLORATORY OBJECTIVES:

I. To evaluate patient-reported quality-of-life (QoL). II. To evaluate volumetric and dosimetric factors associated with acceptable breast cosmesis.

III. To evaluate volumetric and dosimetric factors associated with acute and late radiation-associated toxicities.

OUTLINE:

Patients undergo UF-WBI with CB once daily (QD) on consecutive business days for up to 5 fractions in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo cone-beam computed tomography (CBCT) prior to each radiation treatment.

After completion of study treatment, patients are followed up at 1 month, 6 months, then annually for up to 5 years.

Conditions

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Anatomic Stage I Breast Cancer AJCC v8 Anatomic Stage II Breast Cancer AJCC v8 Anatomic Stage III Breast Cancer AJCC v8 Breast Carcinoma

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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Treatment (UF-WBI with CB)

Patients undergo UF-WBI with CB QD on consecutive business days for up to 5 fractions in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo CBCT prior to each radiation treatment.

Group Type EXPERIMENTAL

Cone-Beam Computed Tomography

Intervention Type PROCEDURE

Undergo CBCT

Hypofractionated External Beam Radiation Therapy

Intervention Type RADIATION

Undergo UF-WBI with CB

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Radiation Boost

Intervention Type RADIATION

Undergo UF-WBI with CB

Whole Breast Irradiation

Intervention Type RADIATION

Undergo UF-WBI with CB

Interventions

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Cone-Beam Computed Tomography

Undergo CBCT

Intervention Type PROCEDURE

Hypofractionated External Beam Radiation Therapy

Undergo UF-WBI with CB

Intervention Type RADIATION

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Radiation Boost

Undergo UF-WBI with CB

Intervention Type RADIATION

Whole Breast Irradiation

Undergo UF-WBI with CB

Intervention Type RADIATION

Other Intervention Names

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Cone Beam Computed Tomography Cone Beam CT BOOST Boost Radiation Boost Radiation Therapy Boost Radiotherapy Radiation Therapy Boost Radiotherapy Boost

Eligibility Criteria

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Inclusion Criteria

* Documented informed consent of the participant and/or legally authorized representative
* Age: ≥ 40 years
* Female
* Ability to read and understand English for questionnaires
* Histologically confirmed breast cancer
* Malignancy must be epithelial. Non-epithelial breast malignancies such as lymphoma or sarcoma are not allowed
* Patients must have undergone breast conserving surgery. Re-excision for negative margins is allowed
* Patients must have undergone surgical staging of the axilla (sentinel lymph node biopsy or axillary lymph node dissection)
* Must have at least one-high risk feature that would necessitate a lumpectomy cavity boost by the treating radiation oncologist
* Patient must have physician-reported "Excellent" or "Good" cosmesis post-lumpectomy and prior to radiation therapy based on the 4-point Global Cosmetic Score
* Women of childbearing potential (WOCBP): negative urine or serum pregnancy test

* If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required
* Childbearing potential defined as not being surgically sterilized (men and women) or have not been free from menses for \> 1 year (women only)

Exclusion Criteria

* Prior radiation to the region of the involved breast that in the opinion of the investigator would preclude breast irradiation
* Pathologically or clinically involved regional lymph nodes necessitating comprehensive regional nodal irradiation that includes the supraclavicular fossa
* Clinically significant uncontrolled illness
* Stage IV breast cancer
* Diagnosis of Paget's disease of the nipple
* Other prior or active malignancy. Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
* Pregnant or breastfeeding
* Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)
Minimum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

City of Hope Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stephanie M Yoon

Role: PRINCIPAL_INVESTIGATOR

City of Hope Comprehensive Cancer Center

Locations

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City of Hope at Arcadia

Arcadia, California, United States

Site Status RECRUITING

City of Hope Medical Center

Duarte, California, United States

Site Status RECRUITING

City of Hope at Irvine Lennar

Irvine, California, United States

Site Status NOT_YET_RECRUITING

City of Hope Antelope Valley

Lancaster, California, United States

Site Status RECRUITING

City of Hope South Pasadena

South Pasadena, California, United States

Site Status RECRUITING

City of Hope at South Bay

Torrance, California, United States

Site Status RECRUITING

City of Hope Upland

Upland, California, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Stephanie M. Yoon

Role: primary

626-873-5241

Stephanie M. Yoon

Role: primary

626-873-5241

Stephanie M. Yoon

Role: primary

626-873-5241

Stephanie M. Yoon

Role: primary

626-873-5241

Stephanie M. Yoon

Role: primary

626-873-5241

Stephanie Yoon, MD

Role: primary

626-359-8111

Stephanie M. Yoon

Role: primary

626-873-5241

Other Identifiers

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NCI-2025-02185

Identifier Type: REGISTRY

Identifier Source: secondary_id

23860

Identifier Type: OTHER

Identifier Source: secondary_id

P30CA033572

Identifier Type: NIH

Identifier Source: secondary_id

View Link

23860

Identifier Type: -

Identifier Source: org_study_id

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