A Phase II Study of Repeat Breast Preserving Surgery and 3D-Conformal Partial Breast Re-Irradiation (PBrI) for Local Recurrence of Breast Carcinoma
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- Breast Cancer
- Sponsor
- Radiation Therapy Oncology Group
- Enrollment
- 65
- Locations
- 58
- Primary Endpoint
- Number of Participants With Grade 3+ Treatment-related Skin, Fibrosis, and Breast Pain Adverse Events
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Giving radiation therapy after surgery kill any remaining tumor cells and may be an effective treatment for breast cancer.
PURPOSE: This phase II trial is studying how well radiation therapy works in treating women with locally recurrent breast cancer previously treated with repeat breast-conserving surgery.
Detailed Description
OBJECTIVES: Primary * To evaluate skin, breast, and chest wall adverse events occurring within 1 year after completion of 3D-conformal partial-breast re-irradiation following repeat breast-preserving surgery in patients with locally recurrent breast carcinoma. Secondary * To evaluate the adverse events occurring after 1 year from the completion of re-irradiation and at any time. * To evaluate in-breast control rate in patients treated with this regimen. * To evaluate freedom-from-mastectomy rate in these patients. * To evaluate the rate of circulating tumor cells (CTCs) in this patient population and to document eradication of CTCs by locoregional therapy. * To determine whether translational objective will correlate with eradication or presence of CTCs with in-breast recurrence and distant metastasis-free survival. * To evaluate cosmesis as judged by the patient and independent evaluation. * To evaluate distant metastasis-free survival, mastectomy-free survival, and overall survival of patients treated with this regimen. OUTLINE: This is a multicenter study. Patients undergo 3-dimensional conformal accelerated partial-breast irradiation twice daily, 5 days a week, for 3 weeks. Some patients undergo blood sample collection at baseline and within 3 weeks after completion of radiotherapy for circulating tumor cells analysis. Some patients complete questionnaires on cosmesis at baseline and at 1 and 3 years following radiotherapy. After completion of study therapy, patients are followed up periodically for 4-5 years and then every year thereafter.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Number of Participants With Grade 3+ Treatment-related Skin, Fibrosis, and Breast Pain Adverse Events
Time Frame: From the end of radiation to 1 year.
Adverse events (AEs) were graded with Common Terminology Criteria for Adverse Events (CTCAE) version 4. Grade refers to the severity of the AE. The Common Terminology Criteria for Adverse Events (CTCAE) v4.0 assigns Grades 1 through 5 with unique clinical descriptions of severity for each AE based on this general guideline: Grade 1 Mild AE, Grade 2 Moderate AE, Grade 3 Severe AE, Grade 4 Life-threatening or disabling AE, Grade 5 Death related to AE. Based on a rate of 4% for the AEs of interest, a rate of ≥ 13% for these AEs with re-irradiation would be unacceptable. A sample size of 55 evaluable pts (eligible \& started protocol treatment) would provide: 86% power to conclude an unacceptable rate of the specified AEs, if the true AE rate was at least 13%; 93% probability to not conclude an unacceptable rate of the specified AEs, if the true AE rate is 4%. If ≥ 5 pts have treatment-related AEs, then the treatment-related AE rate was considered unacceptable.
Secondary Outcomes
- Overall Survival(From registration to date of death or last follow-up. Analysis occurs after all patients have been potentially followed for 3 years.)
- Mastectomy-free Survival(From registration to date of mastectomy, death or last follow-up. Analysis occurs after all patients have been potentially followed for 3 years.)
- Change in Patient-Reported Cosmetic Outcomes From Baseline to 36-Months as Measured by the Breast Cancer Treatment Outcome Scale (BCTOS)(Baseline and 36 months from the start of radiation treatment.)
- Treatment-related Adverse Events (AEs) Any Time(From the end of radiation to end of follow-up. Will be evaluated at the time of the primary analysis.)
- Freedom From Mastectomy(From registration to date of mastectomy or last follow-up. Analysis occurs after all patients have been potentially followed for 3 years.)
- Distant Metastasis-free Survival(From registration to date of distant metastasis, death or last follow-up. Analysis occurs after all patient have been potentially followed for 3 years.)
- In-breast Recurrence(From registration to date of recurrence or last follow-up. Analysis occurs after all patients have been potentially followed for 3 years.)
- Number of Patients With Detectable/Undetectable/Unevaluable Circulating Tumor Cells (CTCs)(Prior to the start of radiation and 3 weeks after last radiation treatment.)
- Treatment-related Adverse Events Occurring After One Year From Completion of Re-irradiation(After 1 year from the end of radiation.)
- Change in Patient-Reported Cosmetic Outcomes From Baseline to 12-Months as Measured by the Breast Cancer Treatment Outcome Scale (BCTOS)(Baseline and 12 months from the start of radiation treatment.)
- 12-Month BCTOS Mean Subscale Scores by 12-Month NRG Oncology/RTOG Cosmetic Rating Scale(12 Months from the start of radiation treatment.)
- Number of Patients With Good/Excellent Cosmesis Using the NRG Oncology/Radiation Therapy Oncology Group (RTOG) Cosmetic Rating Scale(Baseline,12, and 36 Months from the start of radiation treatment.)