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Trial of Tomotherapy in Breast Cancer

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상태
스폰서
Vrije Universiteit Brussel

키워드

요약

Tomotherapy is a new radiation therapy system that uses an integrated CT scanner during delivery of radiation treatment to improve the accuracy of the treatment. Furthermore the irradiation is delivered helicoidally allowing highly conformal shaping of dose distribution. However the magnitude of the clinical advantage of using the system in breast cancer is unknown. The purpose of the present study is to investigate whether or not the Tomotherapy can substantially reduce pulmonary and cardiac toxicities, as compared with conventional radiotherapy.

기술

Prior to surgery: histological confirmation; medical imaging.

Localizing markers are placed in case of breast conserving surgery.

After surgery, patients are randomized to one of two treatment arms:

- Arm I: radiotherapy using tangential chest fields, and supraclavicular field in case of nodal involvement, according to our hospital's standard procedure (Voordeckers M et al, Radiother Oncol 2003;68:227 and 2004;70:225). Dose-fractionation: 50 Gy in 25 fractions over 5 weeks, 2 Gy/fraction. Additional boost 16 Gy in 8 fractions over 2 weeks if breast conserving surgery (verify marker/clip localization) and age <= 70 years.

- Arm II: radiotherapy using the Tomotherapy system. Target area (breast, thorax wall, nodal areas) delimited according to pre-operative imaging and pathological description. Dose-fractionation (adapted from Whelan T et al, JNCI 2002;94:1143): 42 Gy in 15 fractions over 3 weeks, 2.8 Gy/fraction. Simultaneous boost 0.6 Gy/fraction if breast conserving surgery.

Physics quality control is integrated during treatment in both arms.

Radiotherapy begins within 6 weeks after the last breast surgery. Concurrent or sequential adjuvant systemic treatments are allowed. In case of sequential adjuvant treatment with chemotherapy first, radiotherapy begins within 6 weeks after completion of the adjuvant chemotherapy.

Quality of life, arm mobility and edema, pulmonary and heart function are assessed prior to radiotherapy, at 1-3 months after completion of radiotherapy, then yearly.

날짜

마지막 확인: 04/30/2017
처음 제출: 04/10/2007
제출 된 예상 등록: 04/10/2007
처음 게시 됨: 04/11/2007
제출 된 마지막 업데이트: 05/11/2017
마지막 업데이트 게시: 05/15/2017
실제 연구 시작 날짜: 04/30/2007
예상 기본 완료 날짜: 07/31/2011
예상 연구 완료 날짜: 11/30/2017

상태 또는 질병

Breast Neoplasms

개입 / 치료

Radiation: Conventional radiotherapy

Radiation: Tomotherapy

단계

-

팔 그룹

개입 / 치료
Active Comparator: Conventional radiotherapy
Conventional Long schedule Radiotherapy Arm
Radiation: Conventional radiotherapy
Radiation treatment delivered by conventional linear accelerator using matching fields
Experimental: Tomotherapy
Short course schedule by tomotherapy
Radiation: Tomotherapy
CT image guided intensity modulated radiation therapy delivered by the Tomotherapy HiArt system

자격 기준

공부할 수있는 연령 18 Years 에 18 Years
공부할 수있는 성별Female
건강한 자원 봉사자를 받아들입니다
기준

Inclusion Criteria:

- Informed consent

- Histologically proven breast carcinoma

- Stage I or II (T1-3N0 or T1-2N1 M0, AJCC/TNM 6th edition)

- Surgery with clear margins

- Pre-operative medical imaging (at least CT, MRI, and/or PET-scan)

Exclusion Criteria:

- Prior breast or thoracic radiotherapy

- Pregnancy or lactation

- Fertile patients without effective contraception

- Psychiatric or addictive disorders

결과

1 차 결과 측정

1. Change from baseline in pulmonary function and heart function tests [From end of treatment up to 3 years after treatment]

Assessment by pulmonary function tests and by heart echocardiography, compared with test values prior to treatment

2 차 결과 측정

1. Local-regional recurrences. [From end of treatment up to 15 years after treatment]

Local-regional recurrences are assessed at time intervals as per the institution's standard practice for the clinical surveillance of patients.

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