Description:
This phase II trial studies the side effects of intraoperative electron beam radiotherapy
boost and to see how well it works in treating patients with stage I-II breast cancer
undergoing surgery with reconstruction. Giving a single dose of electron beam radiation to
the tumor cavity during the breast surgery before reconstruction may be a better way to kill
tumor cells and shrink tumors.
Title
- Brief Title: Intraoperative Electron Beam Radiotherapy Boost in Treating Patients With Stage I-II Breast Cancer Undergoing Surgery With Reconstruction
- Official Title: Multi-institution Phase II Trial of Intraoperative Electron Beam Radiotherapy Boost at the Time of Breast Conserving Surgery With Oncoplastic Reconstruction in Women With Early-Stage Breast Cancer
Clinical Trial IDs
- ORG STUDY ID:
OSU-16106
- SECONDARY ID:
NCI-2016-01294
- NCT ID:
NCT02927912
Conditions
- Stage IA Breast Cancer
- Stage IB Breast Cancer
- Stage IIA Breast Cancer
- Stage IIB Breast Cancer
Purpose
This phase II trial studies the side effects of intraoperative electron beam radiotherapy
boost and to see how well it works in treating patients with stage I-II breast cancer
undergoing surgery with reconstruction. Giving a single dose of electron beam radiation to
the tumor cavity during the breast surgery before reconstruction may be a better way to kill
tumor cells and shrink tumors.
Detailed Description
PRIMARY OBJECTIVES:
I. To determine the rate of grade 3 breast fibrosis at 1 year in women undergoing lumpectomy
with oncoplastic reconstruction and immediate intraoperative electron radiotherapy boost
followed by adjuvant whole breast radiotherapy.
SECONDARY OBJECTIVES:
I. To determine the rate of 5 year ipsilateral breast tumor recurrence rate. II. To determine
the change in self-reported cosmesis using the Breast Cancer Treatment Outcome Scale (BCTOS)
questionnaire.
III. To evaluate physician-reported cosmetic outcomes using the 4-point Harvard Cosmesis
Scale and digital photographs.
OUTLINE:
Patients undergo standard of care lumpectomy and then undergo 1 fraction of intraoperative
electron beam radiation therapy (IOERT) boost to the lumpectomy cavity. Patients then undergo
standard of care oncoplastic reconstruction and whole breast radiation therapy.
After completion of study treatment, patients are followed up at 1 month, 6 months, 1 year,
and every year thereafter for 5 years.
Trial Arms
Name | Type | Description | Interventions |
---|
Treatment (IOERT boost) | Experimental | Patients undergo standard of care lumpectomy and then undergo 1 fraction of IOERT boost to the lumpectomy cavity. Patients then undergo standard of care oncoplastic reconstruction and whole breast radiation therapy. | |
Eligibility Criteria
Inclusion Criteria:
- Pathologically proven diagnosis of breast cancer
- Clinical node negative stage I (T1N0) or stage II (T2N0) breast cancer
- Preoperative ultrasound of the axilla with biopsy of suspicious nodes is
recommended as clinically indicated per the discretion of the treating physician
- Appropriate stage for protocol entry including no clinical evidence for distant
metastases based upon the following minimum diagnostic workup
- History/physical examination, documentation of weight and Zubrod performance status
0-2 within 28 days prior to study entry
- Right and left mammography within 90 days of diagnostic biopsy establishing diagnosis
- Absolute neutrophil count > 1800 cells/cubic mm
- Platelets >= 75,000 cells/cubic mm
- Hemoglobin >= 8 g/dL
- Women of childbearing potential must have a negative urine or serum pregnancy test
within 14 days of study entry
- Women of childbearing potential must be non-pregnant and non-lactating and willing to
use medically acceptable form of contraception during radiation therapy
- Patients must provide study specific informed consent prior to study entry
Exclusion Criteria:
- Clinical T4, N2 or N3, M1 pathologic stages III or IV breast cancer
- Prior invasive non-breast malignancy (except non-melanoma skin cancer, carcinoma in
situ of the cervix) unless disease free for a minimum of 3 yrs prior to study entry
- Prior invasive or in-situ carcinoma of the breast (prior lobular breast carcinoma in
situ [LCIS] is eligible)
- Two or more cancers not resectable through a single lumpectomy incision
- Bilateral breast cancer
- Ductal breast carcinoma in situ (DCIS) only
- Non-epithelial breast malignancies such as sarcoma/lymphoma
- Male breast cancer
- Paget's disease of the nipple
- Prior radiotherapy to the breast or prior radiation to the region of the ipsilateral
breast that would result in overlap of radiation fields
- Pregnancy or women of childbearing potential who are sexually active and not
willing/able to use medically acceptable forms of contraception
- Active systemic lupus, erythematosus, or any history of scleroderma, dermatomyositis
with active rash
- Medical, psychiatric or other condition that would prevent the patient from receiving
the protocol therapy or providing informed consent
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Female |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Incidence of adverse events in the first 30 patients enrolled as graded by the National Cancer Institute Common Toxicity Criteria version 4.0 |
Time Frame: | Up to 30 days after surgery and IOERT boost |
Safety Issue: | |
Description: | If 4 or more complications in the first 10 patients, 7 or more out of the first 20 patients or 9 or more out of 30 patients are observed, then the study will be deemed not safe to continue. Summary statistics will be used to report all complications. |
Secondary Outcome Measures
Measure: | Change in self-reported cosmesis using the BCTOS |
Time Frame: | Baseline up to 3 years |
Safety Issue: | |
Description: | The mean and standard deviation of the self-reported cosmesis using the BCTOS cosmesis scale will be summarized over time. The change over time using a repeated measures model or non-parametric methods, if appropriate, will be examined. |
Measure: | Physician reported cosmesis using the Harvard Breast Cosmesis scale and digital photographs |
Time Frame: | Up to 3 years after completion of radiation therapy |
Safety Issue: | |
Description: | physician-reported cosmetic outcomes using the 4-point Harvard Cosmesis Scale and digital photographs |
Measure: | Quality of life assessed by Breast Cancer Treatment Outcome Scale |
Time Frame: | Up to 3 years after completion of radiation therapy |
Safety Issue: | |
Description: | determine the rate of surgical complications necessitating hospital readmission or return to the operating room within 30 days of surgery + IOERT |
Measure: | Rate of ipsilateral breast tumor recurrence |
Time Frame: | At 5 years |
Safety Issue: | |
Description: | The exact binomial confidence interval for the rate will be calculated. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Ohio State University Comprehensive Cancer Center |
Last Updated
December 20, 2018