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The Differential Impact of Proton Beam Irradiation Versus Conventional Radiation on Organs-at-risk in Stage II-III Breast Cancer Patients

Recruiting
Conditions
Breast Cancer Stage III
Breast Cancer Stage II
Registration Number
NCT03270072
Lead Sponsor
Massachusetts General Hospital
Brief Summary

The objective of the study is to serve as a correlative study for patients enrolled on the RadCOMP trial (NCT02603341), a randomized phase III study of stage II and III breast cancer patients treated with either conventional photon radiation or proton beam radiation

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Eligible for and scheduled to receive radiation therapy on Radiation Therapy Oncology Group (RTOG) Trial 3510 (Pragmatic Phase III Randomized Trial of Proton vs Photon Therapy for Patients with Non-Metastatic Breast Cancer Receiving Comprehensive Nodal Radiation: A Radiotherapy Comparative Effectiveness (RADCOMP) Consortium Trial). (NCT02603341)
  • Ability to understand and the willingness to sign a study-specific written informed consent document
Exclusion Criteria
  • There are no exclusion criteria.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Change in Global Longitudinal Strain (GLS)Baseline, 6 Months

Comparison of the change in GLS between conventional radiation and proton beam radiation groups. Participants who decrease their GLS by at least 2% 6-8 months following radiation therapy will be considered to demonstrate a significant decrement in GLS.

Secondary Outcome Measures
NameTimeMethod
Incidence of Ipsilateral Arm LymphedemaBaseline, end of treatment (approximately 10 weeks), then 6, 12, 24, 36, and 60 months post treatment

Incidence of ipsilateral arm lymphedema will be estimated in each radiation group by the cumulative incidence function and compared using Gray's test.

Radiation-induced Lung Parenchymal Changes Using CT ImagingBaseline, 3,6,12, months post treatment

Radiation-induced lung parenchymal changes will be assess with non-contrast enhanced computerized tomography (CT) scans and incidence will be estimated in each radiation group by the cumulative incidence function and compared using Gray's test. Among patients who do not have any changes detected, death and disease progression will be considered as competing risks.

Ipsilateral Breast/Chest Wall CosmesisBaseline, end of treatment (approximately 10 weeks), then 6, 12, 24, 36, and 60 months post treatment

Breast cosmesis will be assessed with characteristics graded on a four-point scale. Assessments will be performed by a trained nurse/nurse practitioner using the European Organization for Research and Treatment of Cancer (EORTC) Cosmetic Rating System for Breast Cancer. Incidence of adverse cosmesis (2=fair or 3=poor score) will be estimated in each radiation group by the cumulative incidence function and compared using Gray's test. Among patients without adverse breast cosmesis, death and disease progression will be considered as competing risks.

Change in Left Ventricular Ejection Fraction (LVEF) Using EchocardiographyBaseline, end of treatment (approximately 10 weeks), then 6, 12, 24, 36, and 60 months post treatment

Comparison of the change in LVEF between conventional radiation and proton beam radiation groups. Reduced cardiac function is defined as an ejection fraction \<50%.

Incidence of Thyroid DysfunctionBaseline, end of treatment (approximately 10 weeks), then 12, 24, 36, and 60 months post treatment

Incidence of thyroid insufficiency will be estimated in each radiation group by the cumulative incidence function and compared using Gray's test. In the absence of thyroid dysfunction, death and disease progression will be considered as competing risks.

Severity of Ipsilateral Arm LymphedemaBaseline, end of treatment (approximately 10 weeks), then 6, 12, 24, 36, and 60 months post treatment

Serial arm measurements may be analyzed using mixed effects model to compare the severity of ipsilateral arm lymphedema over time between the radiation groups.

Trial Locations

Locations (1)

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

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