Breast Cancer Clinical Trial
Official title:
A Pilot Study of Four-Dimensional Conformal Image Guided Accelerated Partial Breast Irradiation In The Treatment Of Stage 0 and l Breast Cancer
Verified date | October 2018 |
Source | Yale University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The Purpose of this study is to evaluate the feasibility of using image guidance and four-dimensional computed tomography to reduce the volume of non target breast tissue that is treated with accelerated partial breast irradiation via the external beam technique.
Status | Completed |
Enrollment | 46 |
Est. completion date | July 17, 2017 |
Est. primary completion date | July 17, 2017 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 50 Years and older |
Eligibility |
Inclusion Criteria: - The patient must consent to be in the study and must have a signed an approved consent form conforming with institutional guidelines. - Patient must be > 50 years old. - The patient should have a life expectancy of at least two years with a karnofsky performance status > 70. - The patient must have stage 0 or I breast cancer. - On histological examination, the tumor must be DCIS or invasive adenocarcinoma of the breast. - Surgical treatment of the breast must have been lumpectomy. The margins of the resected specimen must be histologically free of tumor (>2mm, DCIS and invasive). Re-excision of surgical margins is permitted. - Gross disease must be unifocal with pathologic (invasive and/or DCIS) tumor size 2 cm or less. (Patients with microscopic multifocality are eligible as long as total pathologic tumor size is 2 cm or less.) - Patients with invasive breast cancer are required to have axillary staging which can include sentinel node biopsy alone (if negative), sentinel node biopsy followed by axillary dissection or sampling with a minimum total of 6 axillary nodes or axillary dissection alone (with a minimum of 6 axillary nodes). Axillary staging is NOT required for patients with DCIS. - The patient must have simulation within 8 weeks/56 days of the final surgery for their breast cancer (lumpectomy, re-excision of margins, or axillary staging procedure). - Patients with a history of non-ipsilateral breast malignancies are eligible if they have been disease-free for 2 or more years prior to enrollment. Patients with the following cancers are eligible even if diagnosed and treated within the past 2 years: carcinoma in situ of the cervix, colon, melanoma in situ, and basal cell and squamous cell carcinoma of the skin. - Chemotherapy is permitted if planned for = 2 weeks after radiation. - Urine pregnancy test must be performed and be negative on all women younger than 60 who have not had a tubal ligation, oophorectomy, or hysterectomy. - Separate incisions for the lumpectomy and sentinel node biopsy should be present. Use of only one incision will typically result in a contiguous cavity with the tumor bed and the sentinel node sampling, and inability of the radiation oncologist to delineate the tumor bed from the sentinel node bed. - The patient must have a cavity which is able to be targeted with external beam APBI, either through surgical clip placement, or CVS 3 or higher. The cavity to whole breast ratio must be 30% or less. Exclusion Criteria: - Men are not eligible for this study as men are not breast conservation candidates. - T0, T2 (> 2.0 cm), T3, node positive, stage III or IV breast cancer. - Any positive axillary nodes. - Palpable or radiographically suspicious ipsilateral or contralateral axillary, supraclavicular, infraclavicular or internal mammary nodes, unless biopsy proven to be negative for tumor. - Suspicious microcalcifications, densities or palpable abnormalities in either breast unless biopsy proven to be benign. - Non-epithelial breast malignancies such as sarcoma or lymphoma. - Proven multicentric carcinoma in more than one quadrant or separated by more than 2 centimeters. - Paget's disease of the nipple. - History of invasive breast cancer or DCIS in the same breast. - Surgical margins that cannot be microscopically assessed or are less then 2 mm. - Collagen vascular disease, specifically dermatomyositis with a CPK level above normal or with an active skin rash, systemic lupus erythematosis or scleroderma. - Pregnancy or lactation at the time of proposed radiation. Women of reproductive potential must agree to use an effective non-hormonal method of contraception during therapy. - Psychiatric or addictive disorders or other conditions that, in the opinion of the treating physician, would preclude the patient from meeting the study requirements. - Patients with coexisting medical conditions in whom life expectancy is < 2 years. - Patients with skin involvement, regardless of tumor size. |
Country | Name | City | State |
---|---|---|---|
United States | Smilow Cancer Hospital Care Center, Yale New Haven Hospital | New Haven | Connecticut |
Lead Sponsor | Collaborator |
---|---|
Yale University |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Patients With Reduction in Incidental Radiation | Patients were assessed to determine if there was a reduction in breast radiation V50 less than 45% and V100 less than 23.5%. | 5 day | |
Secondary | Cosmesis by Patient Report | This outcome is measured by the Breast Cancer Treatment outcome Scale (BCTOS). Eleven items (e.g., breast size, breast pain, breast shape) are rated by patients on a 4-point scale (0=no difference to 3=large difference), with a score range of 0-33 (higher scores signifying worse outcome). Scores on each item are summed to obtain a total score. | Within no more than 8 weeks of surgery, but prior to the start of radiation | |
Secondary | Cosmesis by Patient Report | This outcome is measured by the Breast Cancer Treatment outcome Scale (BCTOS). Eleven items (e.g., breast size, breast pain, breast shape) are rated by patients on a 4-point scale (0=no difference to 3=large difference), with a score range of 0-33 (higher scores signifying worse outcome). Scores on each item are summed to obtain a total score. | 1 year post treatment | |
Secondary | Cosmesis by Patient Report | This outcome is measured by the Breast Cancer Treatment outcome Scale (BCTOS). Eleven items (e.g., breast size, breast pain, breast shape) are rated by patients on a 4-point scale (0=no difference to 3=large difference), with a score range of 0-33 (higher scores signifying worse outcome). Scores on each item are summed to obtain a total score. | 3 year post treatment | |
Secondary | Cosmesis by Medical Doctor Report | Medical doctor will be provided with cosmesis scale and grade cosmesis of breast. Cosmesis was based on the Harvard Cosmesis Scale rated as :1. excellent: the treated breast looked essentially the same as the opposite breast; 2. good: minimal but identifiable effects of radiation on the treated breast; 3. fair: significant effects of radiation on the breast were noted; 4. severe normal tissue sequelae. | Within no more than 8 weeks of surgery, but prior to the start of radiation | |
Secondary | Cosmesis by Medical Doctor Report | Medical doctor will be provided with cosmesis scale and grade cosmesis of breast. Cosmesis was based on the Harvard Cosmesis Scale rated as :1. excellent: the treated breast looked essentially the same as the opposite breast; 2. good: minimal but identifiable effects of radiation on the treated breast; 3. fair: significant effects of radiation on the breast were noted; 4. severe normal tissue sequelae. | 1 yr post treatment | |
Secondary | Cosmesis by Medical Doctor Report | Medical doctor will be provided with cosmesis scale and grade cosmesis of breast. Cosmesis was based on the Harvard Cosmesis Scale rated as :1. excellent: the treated breast looked essentially the same as the opposite breast; 2. good: minimal but identifiable effects of radiation on the treated breast; 3. fair: significant effects of radiation on the breast were noted; 4. severe normal tissue sequelae. | 3 yr post treatment |
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