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Proton Radiation Therapy for Invasive Breast Cancer Following Mastectomy

Primary Purpose

Invasive Breast Cancer

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Proton Radiation
Sponsored by
Massachusetts General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Invasive Breast Cancer focused on measuring Breast Cancer, Mastectomy

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically confirmed invasive breast cancer confined to the breast and regional lymphatics
  • Completed mastectomy (complete not partial )breast surgery +/- reconstructive surgery
  • Life expectancy > 12 months

Exclusion Criteria:

  • Pregnant or breast-feeding
  • Prior therapeutic radiation > 200 cGy
  • History of a different malignancy unless disease-free for at least 5 years or diagnosed and treated cervical cancer in situ, or basal or squamous cell cancer of the skin
  • Prior investigation chemotherapy

Sites / Locations

  • Massachusetts General Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Proton Radiation

Arm Description

Radiation therapy with proton beam

Outcomes

Primary Outcome Measures

Number of Participants With Grade 3 or Higher Radiation Pneumonitis or Any Grade 4 Adverse Event
To determine the feasibility of using proton radiation for the treatment of invasive breast cancer following mastectomy based on the occurrence of grade 3 or > radiation pneumonitis or any grade 4 adverse event within 3 months after the completion of radiation treatment.

Secondary Outcome Measures

The Number of Participants With Acute Skin Toxicities
Summary of the number of participants with any grade acute skin toxicities. Acute skin toxicity was assessed from the start of treatment until 90 days after the end of treatment. Skin toxicity was assessed using Common Terminology Criteria for Adverse Events (CTCAE 4).
Rate and Severity of Radiation Pneumonitis
The number of participants that experienced radiation pneumonitis within three months of the end of treatment. The participants that experienced radiation pneumonitis are grouped by grade. Adverse events were assessed using Common Terminology Criteria for Adverse Events (CTCAE 4). Grade 1: Mild Grade 2: Moderate Grade 3: Severe Grade 4: Life-Threatening Grade 5: Fatal
Summary of Late Skin Toxicity
A summary of the late skin toxicities experienced by participants. The number of participants effected is shown for each toxicity experienced. Skin toxicities were assessed using Common Terminology Criteria for Adverse Events (CTCAE 4).
To Evaluate Cosmetic Outcome and Patient Satisfaction With Cosmetic Outcome
Acute and Late Toxicity of Breast Reconstruction Following Proton Radiation
Combined summary of the acute (within 3 months of completing treatment) and late (3 months to 5 years after completion of treatment) toxicities experienced by participants thought to be related to breast reconstruction surgery following proton radiation treatment. Toxicities are assessed using Common Terminology Criteria for Adverse Events (CTCAE 4).
The Number of Participants That Needed Unplanned Additional Surgery for Breast Reconstruction
The Number of Participants With Early Signs of Cardiac Effects From Radiation Therapy
The number of participant that had early signs of cardiac effects from radiation therapy as assessed using a Strain Echo-cardiogram. The data from the Echo-cardiogram was evaluated for signs of negative impacts to cardiac function as determined by the treating physician. Parameters considered in the evaluation of the echo-cardiogram by the physician included myocardial velocity, strain, strain rate, and torsion. Blood-based cardiac bio-markers pro-BNP and ultra-sensitive troponin-I were also assessed. Either a clinically meaningful change in the strain echo-cardiogram parameters or clinically meaningful elevation of the bio-markers was sufficient to be considered to have early signs of cardiac effects.
Progression Free Survival
Progression-free survival is defined as the duration from the start of radiation to the date of objective disease progression or death due to any cause, whichever is earlier. Disease progression is defined as the appearance of one or more new lesions.

Full Information

First Posted
April 20, 2011
Last Updated
January 3, 2021
Sponsor
Massachusetts General Hospital
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT01340495
Brief Title
Proton Radiation Therapy for Invasive Breast Cancer Following Mastectomy
Official Title
Pilot Study of Proton Radiation Therapy for Invasive Breast Carcinoma Following Mastectomy
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Unknown status
Study Start Date
June 2011 (undefined)
Primary Completion Date
April 2017 (Actual)
Study Completion Date
January 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Massachusetts General Hospital
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
In this study we are looking at a type of radiation called proton radiation which is known to spare surrounding tissue and organs from radiation. The proton radiation will be delivered using 3D conformal proton radiation or scanned beam/IMPT (Intensity Modulated Proton Radiation Treatment). Proton radiation delivers no dose beyond the region requiring treatment. This may reduce side effects that patients would normally experience with conventional radiation therapy or other means of delivering proton radiation therapy. In this study we are evaluating the effectiveness of using proton radiation delivered to reduce side effects association with radiation treatment.
Detailed Description
Proton radiation will be delivered daily for approximately 5 1/2 weeks. Patients will be assessed weekly for any side effects they may be experiencing. Patients will have follow-up visits 4 weeks after proton therapy ends, at 6 months, 12 months, and then every year for up to five years after treatment. Follow-up visits will include a physical examination, radiological imaging (if necessary), echocardiogram, and laboratory tests.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Invasive Breast Cancer
Keywords
Breast Cancer, Mastectomy

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
70 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Proton Radiation
Arm Type
Experimental
Arm Description
Radiation therapy with proton beam
Intervention Type
Radiation
Intervention Name(s)
Proton Radiation
Intervention Description
45-50.4 Gy(RBE) to the chest wall and 45-50.5 Gy(RBE) once daily, 5 days per week, for approximately 5 1/2 weeks
Primary Outcome Measure Information:
Title
Number of Participants With Grade 3 or Higher Radiation Pneumonitis or Any Grade 4 Adverse Event
Description
To determine the feasibility of using proton radiation for the treatment of invasive breast cancer following mastectomy based on the occurrence of grade 3 or > radiation pneumonitis or any grade 4 adverse event within 3 months after the completion of radiation treatment.
Time Frame
From the start of treatment until 3 months after the end of treatment, median duration of treatment of 6 weeks
Secondary Outcome Measure Information:
Title
The Number of Participants With Acute Skin Toxicities
Description
Summary of the number of participants with any grade acute skin toxicities. Acute skin toxicity was assessed from the start of treatment until 90 days after the end of treatment. Skin toxicity was assessed using Common Terminology Criteria for Adverse Events (CTCAE 4).
Time Frame
From the start of treatment until 3 months after the end of treatment
Title
Rate and Severity of Radiation Pneumonitis
Description
The number of participants that experienced radiation pneumonitis within three months of the end of treatment. The participants that experienced radiation pneumonitis are grouped by grade. Adverse events were assessed using Common Terminology Criteria for Adverse Events (CTCAE 4). Grade 1: Mild Grade 2: Moderate Grade 3: Severe Grade 4: Life-Threatening Grade 5: Fatal
Time Frame
From the start of treatment until 3 months after the end of treatment and was not included in the analysis population.
Title
Summary of Late Skin Toxicity
Description
A summary of the late skin toxicities experienced by participants. The number of participants effected is shown for each toxicity experienced. Skin toxicities were assessed using Common Terminology Criteria for Adverse Events (CTCAE 4).
Time Frame
From 3 months after the end of treatment up to 5 years
Title
To Evaluate Cosmetic Outcome and Patient Satisfaction With Cosmetic Outcome
Time Frame
From the start of treatment until 5 years post treatment
Title
Acute and Late Toxicity of Breast Reconstruction Following Proton Radiation
Description
Combined summary of the acute (within 3 months of completing treatment) and late (3 months to 5 years after completion of treatment) toxicities experienced by participants thought to be related to breast reconstruction surgery following proton radiation treatment. Toxicities are assessed using Common Terminology Criteria for Adverse Events (CTCAE 4).
Time Frame
From the start of treatment until 5 years post treatment
Title
The Number of Participants That Needed Unplanned Additional Surgery for Breast Reconstruction
Time Frame
From the start of treatment until 5 years post treatment
Title
The Number of Participants With Early Signs of Cardiac Effects From Radiation Therapy
Description
The number of participant that had early signs of cardiac effects from radiation therapy as assessed using a Strain Echo-cardiogram. The data from the Echo-cardiogram was evaluated for signs of negative impacts to cardiac function as determined by the treating physician. Parameters considered in the evaluation of the echo-cardiogram by the physician included myocardial velocity, strain, strain rate, and torsion. Blood-based cardiac bio-markers pro-BNP and ultra-sensitive troponin-I were also assessed. Either a clinically meaningful change in the strain echo-cardiogram parameters or clinically meaningful elevation of the bio-markers was sufficient to be considered to have early signs of cardiac effects.
Time Frame
Baseline and then 4 and 8 weeks post treatment
Title
Progression Free Survival
Description
Progression-free survival is defined as the duration from the start of radiation to the date of objective disease progression or death due to any cause, whichever is earlier. Disease progression is defined as the appearance of one or more new lesions.
Time Frame
from the start of treatment until the time of disease progression, up to 5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed invasive breast cancer confined to the breast and regional lymphatics Completed mastectomy (complete not partial )breast surgery +/- reconstructive surgery Life expectancy > 12 months Exclusion Criteria: Pregnant or breast-feeding Prior therapeutic radiation > 200 cGy History of a different malignancy unless disease-free for at least 5 years or diagnosed and treated cervical cancer in situ, or basal or squamous cell cancer of the skin Prior investigation chemotherapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shannon M MacDonald, M.D.
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
31449469
Citation
Jimenez RB, Hickey S, DePauw N, Yeap BY, Batin E, Gadd MA, Specht M, Isakoff SJ, Smith BL, Liao EC, Colwell AS, Ho A, Januzzi JL, Passeri J, Neilan TG, Taghian AG, Lu HM, MacDonald SM. Phase II Study of Proton Beam Radiation Therapy for Patients With Breast Cancer Requiring Regional Nodal Irradiation. J Clin Oncol. 2019 Oct 20;37(30):2778-2785. doi: 10.1200/JCO.18.02366. Epub 2019 Aug 26.
Results Reference
derived

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Proton Radiation Therapy for Invasive Breast Cancer Following Mastectomy

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