Intraoperative Boost Radiotherapy With Electrons (IOERT) Followed By Hypofractionated Whole-Breast Irradiation (WBRT)
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Purpose
The purpose of this research study is to find out the effects (good and bad) of adding a dose of radiation to the area of the cancer during surgery to whole breast radiation therapy (WBRT) after surgery. IOERT is the application of electron radiation directly to the residual tumor or tumor bed during cancer surgery. WBRT is a type of radiation therapy used to treat patients who have cancer in the breast covering the entire breast tissue. Both immediate and long-term effects will be measured.
For patients with certain types of breast cancer, one standard treatment is removal of the area of cancer and a small amount of normal tissue around it followed by breast radiation. The radiation treatment in this situation usually lasts 3 to 5 1/2 weeks of WBRT followed by 5-8 daily radiation treatments at the site where the lump was removed called a "boost". During this study, the single dose of electron irradiation (IOERT) given at the surgical site during the operation will replace the usual 5-8 days of localized radiation and the whole breast radiation will last 3 weeks.
| Condition | Intervention |
|---|---|
| Invasive Lobular and Ductal Carcinoma | Radiation: Hypofractionated Whole Breast Radiation Therapy Radiation: Intraoperative Electron Radiation Therapy |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment |
| Official Title: | Intraoperative Boost Radiotherapy With Electrons (IOERT) Followed By Hypofractionated Whole-Breast Irradiation (WBRT) |
- Assessment of acute and late toxicity [ Time Frame: 5 years ]
Assessment of acute toxicity of breast irradiation according to CTC-toxicity Scoring - systems:
- At the end of Radiation Therapy
- At time of first follow-up investigation (week 8 - 10)
Assessment of late toxicity according to NSABP scoring - systems at 6, 12, 24, 36, 48, and 60 months
- Cosmetic Evaluation [ Time Frame: 5 years ]
Assessment of cosmetic outcome according to 5-point scoring system
- Before Whole Breast Radiation Therapy
- Not earlier than 7 months after Whole Breast Radiation Therapy
- At yearly follow-up (photodocumentation in standardized positions) for 5 years.
- Disease Free Survival [ Time Frame: 5 years ]
- Overall Survival [ Time Frame: 5 Years ]
| Estimated Enrollment: | 200 |
| Study Start Date: | January 2011 |
| Estimated Study Completion Date: | December 2021 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Intraoperative Electron Radiation Therapy
A single dose of electron irradiation given at the surgical site during the operation to remove the cancerous tumor will replace the usual 5-8 days of localized radiation. Hypofractionated Whole Breast Radiation Therapy must start within 14-56 days post operatively.
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Radiation: Hypofractionated Whole Breast Radiation Therapy
Hypofractionated Whole Breast Radiation Therapy must start within 14-56 days postoperatively (week 2-8 post-op)
Intraoperative Electron Radiation Therapy (IOERT) is delivered after completion of the lumpectomy and sentinel node procedure. IOERT is performed on mobile or fixed linac with variable electron energies in the range of 4-12 MeV
Other Name: Mobetron
|
Eligibility
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| Ages Eligible for Study: | 40 Years and older (Adult, Senior) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histological proven invasive breast carcinoma (ductal and lobular)
- Age > 40 years
- Karnofsky performance status >70%
- Single discrete tumor or focal microcalcifications that can be imaged on a specimen radiograph or multifocal disease within the same quadrant with a maximum dimension of 4 cm (invasive foci)
- Nodal Status: NO-1
- Clear surgical margins: R0; min 2mm. Re-excision after IOERT is permitted but not required to achieve (-) margin.
- All grades G1 - G3
- Any hormonal receptor and Her-2 status
- Informed consent
Exclusion Criteria:
- In-situ Carcinoma without invasive component or multifocal disease > 4 cm
- Tumor stage: T3 or 4
- Nodal Status > N1 pathologically
- Surgical margins < 2mm
- Multicentricity
- Previous radiotherapy to the involved breast
- Karnofsky Index < 70%
- Mixed connective tissue diseases e.g. rheumatoid polyarthritis, thromboangitis obliterans, systemic lupus.
- Distant metastases
- Unable to provide written consent
Contacts and Locations
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01295723
| United States, California | |
| St. Joseph Hospital of Orange | Recruiting |
| Orange, California, United States, 92868 | |
| Contact: Nancy Walter 714-734-6220 | |
| Contact: Gitana Davila 714-734-6220 ext 41477 Gitana.Davila@stjoe.org | |
| Principal Investigator: Afshin Forouzannia, M.D. | |
| Sub-Investigator: Robert Ash, M.D. | |
| Sub-Investigator: Venita Williams, M.D. | |
| Sub-Investigator: Jay Harness, M.D. | |
| Sub-Investigator: Michele Carpenter, M.D. | |
| Principal Investigator: | Afshin Forouzannia, M.D. | The Center for Cancer Prevention & Treatment at St. Joseph Hospital of Orange |
More Information
| Responsible Party: | St. Joseph Hospital of Orange |
| ClinicalTrials.gov Identifier: | NCT01295723 History of Changes |
| Other Study ID Numbers: |
11-003 Mobetron |
| First Submitted: | February 11, 2011 |
| First Posted: | February 14, 2011 |
| Last Update Posted: | September 19, 2012 |
| Last Verified: | September 2012 |
Keywords provided by St. Joseph Hospital of Orange:
|
Breast cancer Radiation therapy Mobetron IOERT |
IORT Hypofractionated radiation therapy Partial breast radiation |
Additional relevant MeSH terms:
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Carcinoma, Ductal Carcinoma, Ductal, Breast Carcinoma, Lobular Carcinoma, Intraductal, Noninfiltrating Adenocarcinoma Carcinoma Neoplasms, Glandular and Epithelial |
Neoplasms by Histologic Type Neoplasms Neoplasms, Ductal, Lobular, and Medullary Breast Neoplasms Neoplasms by Site Breast Diseases Skin Diseases |