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Breast CancerNCT03616626

Whole Breast Irradiation vs Twice Daily vs. Once Daily Accelerated Partial Breast Irradiation

A study testing Once Daily APBI, Twice Daily APBI and Whole Breast Irradiation in people with Breast Cancer and Radiation Toxicity, run by National Cancer Institute, Egypt at 1 site in Egypt.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a randomized phase III trial in women with invasive carcinoma of the breast with negative axillary nodes treated by Breast Conserving Surgery (BCS). Eligible, patients will be randomly allocated to receive radiotherapy of 3 Dimensional Conformal Radiation Therapy (3DCRT) Whole Breast Irradiation (WBI) 50 Gray… Read more about this study

Who is it for?
Ages 40 years and older, women only
Conditions the study is for
Breast Cancer, Radiation Toxicity
What is being tested?
Once Daily APBI, Twice Daily APBI and Whole Breast Irradiation
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
91 participants
Where
1 siteEgypt
Study dates
1 Jul 2013to 30 Jun 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Tumor characteristics
  • Histologically confirmed invasive adenocarcinoma of the breast
  • Tumors must be ≤ 3 cm. Gross disease must be unifocal. Negative lymph nodes
  • Hormone receptor status:
  • Estrogen receptor (ER) status known Progesterone status known if ER analysis is negative Marginal or borderline results are considered positive Surgery
  • Tumor removed with conservative breast surgery with adequate margin
Show all 30Show fewer
  • Re-excision of surgical margins allowed
  • No prior breast implants
  • Prior axillary staging required for patients including 1 of the following:
  • Sentinel node biopsy alone (if sentinel node is negative)
  • Sentinel node biopsy followed by axillary dissection if sentinel node is positive)
  • Axillary dissection alone with ≥ 6 axillary nodes
  • Target lumpectomy cavity clearly delineated AND target lumpectomy/whole breast reference volume ≤ 30% based on postoperative pre-randomization CT scan
  • Final surgery (i.e., lumpectomy, re-excision of margins, or axillary staging procedure) within the past 42 days
  • No prior biologic therapy for this malignancy Chemotherapy
  • No prior chemotherapy for this malignancy
  • No concurrent chemotherapy during study radiotherapy Endocrine therapy
  • No prior hormonal therapy for this malignancy
  • Concurrent hormonal therapy allowed provided it is not administered during chemotherapy
  • No concurrent raloxifene, tamoxifen, or other selective estrogen receptor modulating drugs
  • No concurrent hormone replacement therapy Radiotherapy
  • No prior radiotherapy for this malignancy
  • No prior breast or thoracic radiotherapy
  • No concurrent regional nodal irradiation Other
  • No other concurrent anticancer therapy Menopausal status
  • Premenopausal or postmenopausal Performance status
  • WHO 0-1 Other
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective non-hormonal contraception

Who cannot join

  • Multicentric carcinoma in more than 1 quadrant or separated by ≥ 4 cm.
  • Non-epithelial breast malignancies (e.g., sarcoma or lymphoma).
  • Positive axillary nodes.
  • Palpable or radiographically suspicious ipsilateral or contralateral axillary, supraclavicular, infraclavicular, or internal mammary nodes unless there is histologic confirmation that these nodes are negative for tumor.
  • Suspicious microcalcifications, densities, or palpable abnormalities in the ipsilateral or contralateral breast unless biopsied and found to be benign
  • Paget's disease of the nipple
Show all 10Show fewer
  • Previous history of invasive breast cancer or DCIS.
  • Synchronous bilateral invasive or non-invasive breast cancer
  • Collagen vascular disease (e.g., systemic lupus erythematosus or scleroderma), specifically dermatomyositis with a CPK level above normal, or active skin rash
  • Psychiatric or addictive disorder that would preclude study therapy

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • National Cancer Institute

    Cairo, 11796

Other trials in Egypt

About this study

Official title: Phase III Randomized Study of Adjuvant Whole Breast Versus Partial Breast Irradiation Using Once Daily or Twice Daily Fractionation Scheme in Women With Stage I or II Breast Cancer

This is a randomized phase III trial in women with invasive carcinoma of the breast with negative axillary nodes treated by Breast Conserving Surgery (BCS). Eligible, patients will be randomly allocated to receive radiotherapy of 3 Dimensional Conformal Radiation Therapy (3DCRT) Whole Breast Irradiation (WBI) 50 Gray (Gy) in 25 daily fractions over 5 weeks or Accelerated Partial Breast Irradiation (APBI) 38.5 Gy in 10 daily fractions of 3.85Gy over two weeks or 38.5 Gy in 10 twice daily fractions of 3.85Gy over one week. Patients will be followed at 6, 12, 18 and 24 months post randomization. Cosmetic outcome will be measured using photographs and evaluated by a panel of trained radiation oncologists. Radiation toxicity will be assessed using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE).

Read the detailed description

Women with invasive carcinoma of the breast less than 3 cm with negative axillary nodes , following BCS, who meet the inclusion criteria will be approached for potential study enrollment.

Eligible, consenting patients will be randomly allocated to receive radiotherapy of 3DCRT WBI 50 Gy in 25 fractions over 5 weeks or APBI 38.5 Gy in 10 once daily fractions of 3.85Gy over two weeks or 38.5 Gy in 10 twice daily fractions of 3.85 Gy over one week. Patients will be followed at 6, 12, 18 and 24 months post randomization. Cosmetic outcome will be measured using photographs and evaluated by a panel of trained radiation oncologists using the EORTC Breast Cosmetic Rating System. Radiation toxicity will be assessed using the NCI CTCAE version 4.0. The primary outcome is to compare the acute, late toxicities and adverse cosmetic outcomes at 6, 12 and 18 months among the three groups.

Being tested
Once Daily APBI, Twice Daily APBI, Whole Breast Irradiation
Keywords
Breast Cancer, Accelerated partial Breast Irradiation, Breast cosmesis, radiation Toxicity
Medical subject headings
Breast Neoplasms, Radiation Injuries

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Once Daily APBIRadiation

    Adjuvant 3D Conformal Accelerated Partial Breast Irradiation to a dose of 38.5 Gy in 10 once daily fractions given over 2 weeks

  • Twice Daily APBIRadiation

    Adjuvant 3D Conformal Accelerated Partial Breast Irradiation to a dose of 38.5 Gy in 10 twice daily fractions given over 1 week

  • Whole Breast IrradiationRadiation

    Adjuvant 3D Conformal Radiation Therapy to a dose of 50 Gy in 25 fractions over 5 weeks. Boost is given as 10 Gy in 5 fractions over one week to patients with high grade tumors or age younger than 50 years

Study groups in NCT03616626
Study groupRoleWhat they receive
Whole Breast IrradiationActive comparatorAdjuvant 3D Conformal Radiation Therapy to a dose of 50 Gy in 25 fractions over 5 weeks. Boost is given as 10 Gy in 5 fractions over one week to patients with high grade tumors or age younger than 50 years
Receives: Radiation: Whole Breast Irradiation
Once Daily APBIExperimentalAdjuvant 3D Conformal Accelerated Partial Breast Irradiation to a dose of 38.5 Gy in 10 once daily fractions given over 2 weeks
Receives: Radiation: Once Daily APBI
Twice Daily APBIExperimentalAdjuvant 3D Conformal Accelerated Partial Breast Irradiation to a dose of 38.5 Gy in 10 twice daily fractions given over 1 week
Receives: Radiation: Twice Daily APBI

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in the Adverse cosmetic outcome using the EORTC Breast Cosmetic Rating System

    The primary outcome is the change in the adverse cosmesis assessed prior to radiation, 6, 12 and 18 months after end of radiation. The cosmetic outcome will be assessed by a radiation oncologist who is unaware of treatment allocation, using the EORTC Breast Cosmetic Rating System.

    Measured: prior to radiation, 6,12 and 18 months after radiation

Secondary outcomes (4)
  1. Ipsilateral Breast Tumor Recurrence (IBTR)

    defined as recurrent invasive or in situ cancer in the ipsilateral breast. Histological evidence of local recurrence will be required.

    Measured: throughout the study up to 5 years

  2. Disease Free Survival

    defined as the time from randomization to the time of documented recurrent disease in the ipsilateral breast or regional nodes (supraclavicular, axillary or internal mammary) or distant sites (e.g. bone, liver, lung or brain).

    Measured: throughout the study up to 5 years

  3. Overall Survival

    defined as the time from randomization to death from any cause

    Measured: From date of randomization until the date of death up to 5 years

  4. Radiation Induced Early and late toxicities

    using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v.4.0

    Measured: during radiation and at 6, 12 and 18 months after radiation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Aug 2018
  2. Study start1 Jul 2013
  3. Primary completion30 Jun 2018
  4. Study completion30 Jun 2021 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
91 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03616626
Sponsor's protocol ID
NCI-BC-12/2012
Status last verified
Jul 2020
First submitted
28 Jul 2018
Last updated
28 Jul 2020
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Hepel JT, Tokita M, MacAusland SG, Evans SB, Hiatt JR, Price LL, DiPetrillo T, Wazer DE. Toxicity of three-dimensional conformal radiotherapy for accelerated partial breast irradiation. Int J Radiat Oncol Biol Phys. 2009 Dec 1;75(5):1290-6. doi: 10.1016/j.ijrobp.2009.01.009. Epub 2009 Apr 22.

    PubMed 19395195
  • Jagsi R, Ben-David MA, Moran JM, Marsh RB, Griffith KA, Hayman JA, Pierce LJ. Unacceptable cosmesis in a protocol investigating intensity-modulated radiotherapy with active breathing control for accelerated partial-breast irradiation. Int J Radiat Oncol Biol Phys. 2010 Jan 1;76(1):71-8. doi: 10.1016/j.ijrobp.2009.01.041.

    PubMed 19409733
  • Vicini F, Winter K, Wong J, Pass H, Rabinovitch R, Chafe S, Arthur D, Petersen I, White J, McCormick B. Initial efficacy results of RTOG 0319: three-dimensional conformal radiation therapy (3D-CRT) confined to the region of the lumpectomy cavity for stage I/ II breast carcinoma. Int J Radiat Oncol Biol Phys. 2010 Jul 15;77(4):1120-7. doi: 10.1016/j.ijrobp.2009.06.067. Epub 2009 Nov 10.

    PubMed 19910132
  • Chen PY, Wallace M, Mitchell C, Grills I, Kestin L, Fowler A, Martinez A, Vicini F. Four-year efficacy, cosmesis, and toxicity using three-dimensional conformal external beam radiation therapy to deliver accelerated partial breast irradiation. Int J Radiat Oncol Biol Phys. 2010 Mar 15;76(4):991-7. doi: 10.1016/j.ijrobp.2009.03.012. Epub 2009 Jun 8.

    PubMed 19515514
  • Goyal S, Daroui P, Khan AJ, Kearney T, Kirstein L, Haffty BG. Three-year outcomes of a once daily fractionation scheme for accelerated partial breast irradiation (APBI) using 3-D conformal radiotherapy (3D-CRT). Cancer Med. 2013 Dec;2(6):964-71. doi: 10.1002/cam4.157. Epub 2013 Oct 31.

    PubMed 24403270
  • DE Paula U, D'Angelillo RM, Barbara R, Caruso C, Gomellini S, Caccavari A, Costarelli L, Scavina P, Mauri M, Santini E, Antonaci A, Cavaliere F, LA Pinta M, Loreti A, Fortunato L. Once Daily Accelerated Partial Breast Irradiation: Preliminary Results with Helical Tomotherapy(R). Anticancer Res. 2016 Jun;36(6):3035-9.

    PubMed 27272823
  • Bentzen SM, Yarnold JR. Reports of unexpected late side effects of accelerated partial breast irradiation--radiobiological considerations. Int J Radiat Oncol Biol Phys. 2010 Jul 15;77(4):969-73. doi: 10.1016/j.ijrobp.2010.01.059. No abstract available.

    PubMed 20610037

Questions about this trial

What is this clinical trial studying?

A study testing Once Daily APBI, Twice Daily APBI and Whole Breast Irradiation in people with Breast Cancer and Radiation Toxicity, run by National Cancer Institute, Egypt at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 30 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 28 Jul 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in the Adverse cosmetic outcome using the EORTC Breast Cosmetic Rating System (time frame: prior to radiation, 6,12 and 18 months after radiation). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03616626, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jul 2020; AzTrials last refreshed its copy on 7 Nov 2026.

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