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Active, not recruitingNCT03269981Updated Nov 27, 2023

Randomized Study of Elective Regional Lymph Node Irradiation in N1 Breast Cancer

An interventional study of Whole breast irradiation and Whole breast and nodal irradiation in Breast Neoplasm, sponsored by Samsung Medical Center. Active, not recruiting at 1 site in Korea, Republic of. Open to female participants aged 20 Years to 70 Years. Per ClinicalTrials.gov, last updated 2023-11-27.

Sponsored by Samsung Medical Center · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
827
Allocation
Randomized
Ages
20 Years to 70 Years
Sex
Female
01

Study summary

This study evaluates the impact of elective regional lymph node irradiation on N1 breast cancer patients receiving post-lumpectomy radiotherapy and anthracycline plus taxane (AT)-based chemotherapy. We randomly assign patients having one to three metastatic lymph nodes (pN1) after breast-conserving surgery (BCS) and AT-based chemotherapy to undergo either whole-breast and regional nodal irradiation (WB+RNI group) or whole-breast irradiation alone (WBI group).

Read the detailed description

Objective:

  • Compare the effect of post-BCS WBI vs. WB+RNI on disease-free survival in pN1 breast cancer patients who received AT-based chemotherapy.
  • Evaluate the impact of WBI or WB+RNI according to molecular subtype of tumor.
  • Compare the treatment-related toxicities between the WBI and WB+RNI.
  • Compare the patient's quality of life between the WBI and WB+RNI.

Outline: This is a a randomized, multi-center, phase III study. Patients are stratified according to molecular subtype of tumor (luminal A vs luminal vs luminal HER2 vs HER2-enriched vs basal-like), axillary lymph node management (sentinel lymph node biopsy [SLN] only vs axillary lymph node dissection+/- SLN) and participating institutions. Patients are randomized to one of two treatment arms.

  • Arm I: Patients receive WB+RNI.
  • Arm II: Patients receive WBI alone.

Arm circumference and quality of life (EORTC QLQ-C30 \& EORTC QLQ-BR23) are assessed within 2 weeks prior to randomization, during the last week of radiotherapy, at 3 months after completion of radiotherapy, and then annually thereafter for five years.

Patients are followed at 3 months after completion of radiotherapy and annually thereafter for seven years.

02

Conditions studied

  • Breast Neoplasm

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Keywords

  • Adjuvant radiotherapy
  • Lymphatic irradiation
  • Taxane
  • Anthracycline
  • Prospective study
03

Who can participate

Ages eligible
20 Years to 70 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Histologically proven invasive carcinoma of the breast.
  • One to three positive axillary lymph nodes (pN1) proven in pathologic specimen.
  • Prior breast-conserving surgery and post-operative adjuvant chemotherapy including taxane.
  • Administering adjuvant hormonal therapy in cases with hormone receptor-positive tumor.
  • Administering anti-HER2 therapy in cases with HER2-positive tumor.

Exclusion criteria

Exclusion Criteria:

  • Metastases in supraclavicular or internal mammary lymph nodes.
  • Metastases in distant organs.
  • Neoadjuvant chemotherapy or hormone therapy before surgery.
  • Not receiving adjuvant anthracycline and taxane.
  • Bilateral breast cancer
  • Previous history of radiotherapy of the ipsilateral breast or supraclavicular lymph nodes.
  • Prior history of other types of cancer, except thyroid cancer, carcinoma in situ of the cervix, or skin cancer.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
827 participants (actual)

Study arms

  • Experimental
    Whole breast irradiation

    Post-lumpectomy radiotherapy to the whole breast alone.

    Radiation: Whole breast irradiation

  • Active comparator
    Whole breast and nodal irradiation

    Post-lumpectomy radiotherapy to the whole breast and regional lymph node.

    Radiation: Whole breast and nodal irradiation

Interventions

  • RadiationWhole breast irradiation

    Radiotherapy to the whole breast alone.

  • RadiationWhole breast and nodal irradiation

    Radiotherapy to the whole breast and regional lymph nodes.

05

What researchers measure

Primary outcomes

  1. Disease-free survival

    Disease-free survival

    Time frame: 7 years

Secondary outcomes

  1. Disease-free survival according to molecular subtype

    Disease-free survival according to molecular subtype

    Time frame: 5 years

  2. Treatment-related toxicity

    acute and chronic toxicities

    Time frame: 5 years

  3. European Organization for Research and Treatment of Cancer (EORTC)-Quality of life. Questionnaire 30 (QLQ-C30) measurement

    1 (Not at all) to 4 (Very much), 1 (Very poor) to 7 (Excellent). For functional and global quality of life scales, higher scores mean a better level of functioning. For symptom-oriented scales, a higher score means more severe symptoms.

    Time frame: 5 years

  4. EORTC Quality of Life Questionnaire - Breast Cancer Module (EORTC QLQ-BR23) measurement

    1 (Not at all) to 4 (Very much). A higher score means more severe symptoms.

    Time frame: 5 years

06

Study locations

1 site
  • Samsung Medical Center
    Seoul, 06351, Korea, Republic of
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03269981
Lead sponsor
Samsung Medical Center
Collaborators
Korean Radiation Oncology Group, Ministry of Health, Republic of Korea
Responsible party
Sponsor
First posted
Sep 1, 2017
Start date
Apr 1, 2017
Primary completion
Dec 30, 2029 (estimated)
Completion
Dec 30, 2029 (estimated)
Last update
Nov 27, 2023

Study contacts

Won Park, MD
study chair · Samsung Medical Center

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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