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Efficacy of IORT With CT-Guided HDR Brachytherapy for Treatment of Breast Cancer

Not Applicable
Active, not recruiting
Conditions
Breast Cancer
Interventions
Device: IORT with CT-Guided HDR Brachytherapy
Registration Number
NCT02400658
Lead Sponsor
Shayna Showalter, MD
Brief Summary

The purpose of this study is to evaluate an investigational way to provide radiation therapy to treat early-stage breast cancer at the time of surgery.

Detailed Description

This is a prospective single-arm phase II study designed to study the efficacy of high dose rate (HDR) brachytherapy with CT-imaging, single-fraction intraoperative radiation therapy (IORT). The study will accrue patients with early-stage breast cancer who will be treated with breast-conserving surgery (BCS). The main clinical eligibility criterion is based on suitability for accelerated partial breast irradiation. Patients may be eligible prior to receiving BCS or within 30 days of receiving BCS. Eligible patients that will undergo BCS will receive surgery according to the standard clinical practice in the Brachytherapy Suite in the Emily Couric Clinical Cancer Center. Patients that have already undergone BCS must meet all other eligibility criteria and are able to be treated with IORT within 30 days of their breast surgery. Eligible subjects will undergo a lumpectomy or re-excision lumpectomy according the standard clinical practice. Immediately following lumpectomy, the breast HDR brachytherapy applicator will be placed and CT imaging will be performed for treatment planning. After HDR brachytherapy is delivered, the applicator will be removed, and the breast surgeon will complete the skin closure. Although the ultimate goal of the study is to determine 5-year ipsilateral breast tumor recurrence (IBTR), all efforts will be made to follow the patients until death.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
358
Inclusion Criteria
  1. Patient has elected breast conserving surgery or whole breast irradiation treatment for early-stage breast cancer.
  2. Tumor size must be less than or equal to 3 cm.
  3. Patient is 45 years of age or older.
Exclusion Criteria
  1. Male patients.
  2. Pregnant patients.
  3. Breast cancer that involves the skin or chest wall.
  4. History of ipsilateral breast cancer.
  5. Multicentric breast cancer in the ipsilateral breast.
  6. Known BRCA gene mutation.
  7. Patient with nodal disease.
  8. Patient is undergoing initial medical treatment (hormone or chemotherapy) to reduce tumor size.
  9. Patient with breast implants (does not include patients having implants AFTER intra-operative radiotherapy).

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
IORT with CT-Guided HDR BrachytherapyIORT with CT-Guided HDR BrachytherapyPatients will receive IORT with CT-guided HDR brachytherapy at the time of breast surgery.
Primary Outcome Measures
NameTimeMethod
Rate of Local Breast Tumor RecurrenceUp to 60 Months After Treatment
Secondary Outcome Measures
NameTimeMethod
Rate of Ipsilateral Breast Tumor (Not Local) RecurrenceUp to 60 Months After Treatment
Rate of Distant Recurrence of Breast CancerUp to 60 Months After Treatment
Cancer Specific-Survival and Overall Survival Response RateMinimum of 60 Months After Treatment
Changes of Radiographic Breast AppearanceUp to 60 Months After Treatment
Changes in Reported Patient and Physician Cosmetic DescriptionsUp to 60 Months After Treatment
Comparison of Pre-and Post Pathology StratumUp to 60 Months After Treatment
Number of Participants with Adverse Events24 Months After Treatment

Safety and toxicity of treatment will be determined with the Common Toxicity Criteria for Adverse Effects.

Changes in Patient-Reported Quality of LifeUp to 60 Months After Treatment

Trial Locations

Locations (3)

Hackensack Meridian Health - John Theurer Cancer Center

🇺🇸

Hackensack, New Jersey, United States

University of Virginia

🇺🇸

Charlottesville, Virginia, United States

Thomas Jefferson University

🇺🇸

Philadelphia, Pennsylvania, United States

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