TRI-fraction Radiotherapy Utilized to Minimize Patient Hospital Trips : A Phase II Trial (TRIUMPH-T Trial)
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- Ductal Breast Carcinoma In Situ
- Sponsor
- Rutgers, The State University of New Jersey
- Enrollment
- 200
- Locations
- 10
- Primary Endpoint
- Number of Participants With Adverse Events Greater Than Grade 2 Serious Toxicity Rate, Defined as Toxicity Greater Than Grade 2 Using Common Terminology Criteria for Adverse Events Version 4.0 Criteria
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
This phase II trial studies how well accelerated partial breast irradiation (APBI) using high-dose rate (HDR) brachytherapy works in treating patients with breast cancer that has not spread beyond the breast or the axillary lymph nodes (early-stage) after surgery. Radiation therapy uses a type of energy to kill cancer cells and shrink tumors. Brachytherapy is a type of internal radiation therapy that provides radiation inside the breast to any remaining tumor cells next to the space where the tumor was removed, and is given over a shorter amount of time than standard radiation therapy. Giving accelerated partial breast irradiation (APBI) using high-dose rate (HDR) brachytherapy may reduce the overall time that radiation is delivered to the tumor cells.
Detailed Description
PRIMARY OBJECTIVES: I. To determine the toxicity rate with shorter courses of accelerated partial breast irradiation (APBI) delivered with a breast brachytherapy applicator. SECONDARY OBJECTIVES: I. To determine the 3-year actuarial local control rate with abbreviated accelerated partial breast irradiation (APBI). II. To assess the rate of excellent or good cosmesis at 2-years after shorter courses of APBI and to identify co-variants associated with and predictive of poor cosmetic outcome in women treated with an overnight treatment course of APBI. OUTLINE: Within 1-5 days after balloon placement, patients undergo accelerated partial breast irradiation (APBI) using high-dose rate (HDR) brachytherapy over 15-60 minutes for 2-3 days. After completion of study treatment, patients are followed up at 2-8 weeks and then at least annually for 2 years.
Investigators
Bruce G Haffty
Principal Investigator
Rutgers Cancer Institute of New Jersey
Eligibility Criteria
Inclusion Criteria
- •Must sign informed consent
- •Surgical treatment of the breast must have been lumpectomy; the margins of the resected specimen must be histologically free of tumor (negative surgical margins per National Surgical Adjuvant Breast and Bowel Project \[NSABP\] criteria)
- •On histologic examination, the tumor must be ductal carcinoma in situ (DCIS) and/or invasive breast carcinoma
- •For patients with invasive breast cancer, an axillary staging procedure must be performed (either sentinel node biopsy \[SNB\] alone or axillary dissection \[with a minimum of six axillary nodes removed\], and the axillary node\[s\] must be pathologically negative); patients over 70 with estrogen receptor positive (ER+) tumors no greater than 2 cm do not require axillary evaluation, but MUST be clinically node negative on examination and all available imaging (clinical N0)
- •The T stage must be Tis, T1, or T2; if T2, the tumor must be =\< 3.0 cm in maximum diameter
- •Estrogen receptor positive tumor and/or progesterone receptor positive tumor
Exclusion Criteria
- •Pregnant or breast-feeding
- •Active collagen-vascular disease
- •Paget's disease of the breast
- •Prior history of DCIS or invasive breast cancer
- •Prior breast or thoracic radiation therapy (RT) for any condition
- •Multicentric carcinoma (DCIS or invasive)
- •Synchronous bilateral invasive or non-invasive breast cancer
- •Surgical margins that cannot be microscopically assessed or that are positive
- •Positive axillary node(s)
- •T stage of T2 with the tumor \> 3 cm in maximum diameter or a T stage \>= 3
Outcomes
Primary Outcomes
Number of Participants With Adverse Events Greater Than Grade 2 Serious Toxicity Rate, Defined as Toxicity Greater Than Grade 2 Using Common Terminology Criteria for Adverse Events Version 4.0 Criteria
Time Frame: 2 years
Measured by the data collected for toxicity and cosmesis as dichotomous variables. This will be assessed by physical examination at each follow-up visit. To be scored as a serious toxicity counting toward the primary endpoint, the toxicity must have a "probable" or "definite" attribution to the study treatment.
Secondary Outcomes
- Local Control Rate, Assessed by Physical Examination(3 years)
- Number of Participants With Good/Excellent Cosmetic Results, Using the Harvard Cosmesis Scale(2 years)
- Local Control Rate, Assessed by Mammography(3 years)