Fatigue following radiotherapy of low-risk early breast cancer - a randomized controlled trial of intraoperative electron radiotherapy versus standard hypofractionated whole-breast radiotherapy: the COSMOPOLITAN trial (NCT03838419).


Journal

Radiation oncology (London, England)
ISSN: 1748-717X
Titre abrégé: Radiat Oncol
Pays: England
ID NLM: 101265111

Informations de publication

Date de publication:
01 Jun 2020
Historique:
received: 06 03 2020
accepted: 20 05 2020
entrez: 4 6 2020
pubmed: 4 6 2020
medline: 13 4 2021
Statut: epublish

Résumé

Fatigue is one of the most common and distressing side-effects of breast cancer radiotherapy. According to current guidelines, accelerated partial breast irradiation (APBI) may be considered as an alternative treatment option for women with early-stage low-risk breast cancer. One method for APBI is single-dose intraoperative radiotherapy (IORT) applied directly to the tumor bed during breast conserving surgery (BCS). The COSMOPOLITAN trial therefore aims to analyze the intensity of fatigue following single-shot IORT with electrons (IOERT) compared to conventional hypofractionated whole breast irradiation (WBI) in low risk early breast cancer patients. This trial is conducted as a multicenter, prospective, randomized, two-arm phase II study comparing the intensity of fatigue in early-stage breast cancer (cT1cN0cM0, tumor size < 2,5 cm, ER pos. Her2neu neg., age > 50 years) treated either with WBI or APBI after BCS. Secondary outcomes investigated are tumor control, overall survival (OS), disease-free survival (DFS), acute and chronic toxicity, quality of life (QoL) and cosmesis. A total of 202 patients will be randomized into two arms: Patients in arm A will receive WBI (40.05 Gy, 15 fractions) after surgical resection, while patients in arm B will receive IOERT (21 Gy to the 90%-isodose) during BCS. Fatigue will be assessed 12 weeks post surgery with the help of the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale. The present trial aims to evaluate treatment response to compare single-shot intraoperative electron APBI to conventional WBI following BCS in early-stage low risk breast cancer patients. Fatigue is selected as the primary, patient-reported endpoint due its major clinical relevance. The study is prospectively registered on February 12th, 2019: Clinicaltrials.gov, NCT03838419. "Intraoperative Electron Radiotherapy for Low-risk Early Breast Cancer (COSMOPOLITAN)". Ongoing study. Start of recruitment was December 2019.

Sections du résumé

BACKGROUND BACKGROUND
Fatigue is one of the most common and distressing side-effects of breast cancer radiotherapy. According to current guidelines, accelerated partial breast irradiation (APBI) may be considered as an alternative treatment option for women with early-stage low-risk breast cancer. One method for APBI is single-dose intraoperative radiotherapy (IORT) applied directly to the tumor bed during breast conserving surgery (BCS). The COSMOPOLITAN trial therefore aims to analyze the intensity of fatigue following single-shot IORT with electrons (IOERT) compared to conventional hypofractionated whole breast irradiation (WBI) in low risk early breast cancer patients.
METHODS METHODS
This trial is conducted as a multicenter, prospective, randomized, two-arm phase II study comparing the intensity of fatigue in early-stage breast cancer (cT1cN0cM0, tumor size < 2,5 cm, ER pos. Her2neu neg., age > 50 years) treated either with WBI or APBI after BCS. Secondary outcomes investigated are tumor control, overall survival (OS), disease-free survival (DFS), acute and chronic toxicity, quality of life (QoL) and cosmesis. A total of 202 patients will be randomized into two arms: Patients in arm A will receive WBI (40.05 Gy, 15 fractions) after surgical resection, while patients in arm B will receive IOERT (21 Gy to the 90%-isodose) during BCS. Fatigue will be assessed 12 weeks post surgery with the help of the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale.
DISCUSSION CONCLUSIONS
The present trial aims to evaluate treatment response to compare single-shot intraoperative electron APBI to conventional WBI following BCS in early-stage low risk breast cancer patients. Fatigue is selected as the primary, patient-reported endpoint due its major clinical relevance.
TRIAL REGISTRATION BACKGROUND
The study is prospectively registered on February 12th, 2019: Clinicaltrials.gov, NCT03838419. "Intraoperative Electron Radiotherapy for Low-risk Early Breast Cancer (COSMOPOLITAN)".
STUDY STATUS METHODS
Ongoing study. Start of recruitment was December 2019.

Identifiants

pubmed: 32487184
doi: 10.1186/s13014-020-01581-9
pii: 10.1186/s13014-020-01581-9
pmc: PMC7268450
doi:

Banques de données

ClinicalTrials.gov
['NCT03838419']

Types de publication

Clinical Trial, Phase II Journal Article Multicenter Study Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

134

Références

Lancet Oncol. 2018 Jun;19(6):834-844
pubmed: 29695348
J Pain Symptom Manage. 1997 Feb;13(2):63-74
pubmed: 9095563
Lancet. 2011 Nov 12;378(9804):1707-16
pubmed: 22019144
Lancet Oncol. 2015 Mar;16(3):266-73
pubmed: 25637340
N Engl J Med. 2004 Sep 2;351(10):963-70
pubmed: 15342804
Int J Radiat Oncol Biol Phys. 1999 Oct 1;45(3):667-76
pubmed: 10524421
Cancer. 2018 May 1;124(9):2026-2035
pubmed: 29437204
BMC Cancer. 2014 Mar 13;14:177
pubmed: 24625003
Cancer. 2006 Feb 15;106(4):751-8
pubmed: 16400678
Radiother Oncol. 2009 Jan;90(1):14-22
pubmed: 18502528
J Clin Oncol. 2000 Feb;18(4):743-53
pubmed: 10673515
Lancet. 2016 Jan 16;387(10015):229-38
pubmed: 26494415
Radiat Oncol. 2017 Mar 23;12(1):60
pubmed: 28335784
J Pain Symptom Manage. 2005 Nov;30(5):433-42
pubmed: 16310617
Nat Rev Clin Oncol. 2014 Oct;11(10):597-609
pubmed: 25113839
Radiother Oncol. 2013 Aug;108(2):197-202
pubmed: 23742961
Cancer. 2002 Jan 15;94(2):528-38
pubmed: 11900238
Br J Surg. 1999 Jan;86(1):84-7
pubmed: 10027366
Plast Reconstr Surg. 2011 Mar;127(3):1361-7
pubmed: 21088640
Eur J Cancer. 2020 Mar;127:12-20
pubmed: 31962198
BMC Cancer. 2013 Mar 28;13:162
pubmed: 23537231
Radiother Oncol. 2015 Jan;114(1):3-10
pubmed: 25630428
Breast J. 2003 Mar-Apr;9(2):106-12
pubmed: 12603383
J Clin Oncol. 1997 Jan;15(1):223-9
pubmed: 8996146
Int J Radiat Oncol Biol Phys. 2007 Jun 1;68(2):334-40
pubmed: 17363187
J Clin Oncol. 2014 Feb 20;32(6):557-63
pubmed: 24419112
Radiother Oncol. 2016 Jan;118(1):205-8
pubmed: 26791404
Stat Methods Med Res. 2007 Jun;16(3):219-42
pubmed: 17621469
Breast Cancer Res Treat. 2017 Apr;162(2):329-342
pubmed: 28132391
N Engl J Med. 2002 Oct 17;347(16):1233-41
pubmed: 12393820
J Clin Oncol. 2007 Oct 1;25(28):4387-95
pubmed: 17785709
Breast Care (Basel). 2017 Jul;12(3):172-183
pubmed: 28785186
J Clin Oncol. 2013 Jul 1;31(19):2382-7
pubmed: 23690420
Lancet. 2005 Dec 17;366(9503):2087-106
pubmed: 16360786
Breast. 2018 Apr;38:58-65
pubmed: 29248875
Cancer. 2011 Sep 15;117(18):4116-24
pubmed: 21365631
Lancet Oncol. 2013 Dec;14(13):1269-77
pubmed: 24225155
Lancet. 2010 Jul 10;376(9735):91-102
pubmed: 20570343
Int J Oncol. 2002 Nov;21(5):1093-9
pubmed: 12370760
Oncologist. 2000;5(5):353-60
pubmed: 11040270
Lancet. 2014 Feb 15;383(9917):603-13
pubmed: 24224997
J Clin Oncol. 2005 Nov 20;23(33):8280-2
pubmed: 16219929
J Cancer Surviv. 2012 Mar;6(1):11-9
pubmed: 22160661
Plast Reconstr Surg. 2009 Aug;124(2):345-53
pubmed: 19644246
Int J Radiat Oncol Biol Phys. 2011 Nov 1;81(3):795-803
pubmed: 20888704
J Natl Compr Canc Netw. 2017 May;15(5S):682-684
pubmed: 28515243
Lancet. 2017 Sep 9;390(10099):1048-1060
pubmed: 28779963
Psychooncology. 2014 May;23(5):481-92
pubmed: 24375630
Eur J Cancer. 2013 Jul;49(10):2294-302
pubmed: 23523089
Int J Radiat Oncol Biol Phys. 2016 Oct 1;96(2):259-265
pubmed: 27478165
Cancer Invest. 2000;18(1):11-9
pubmed: 10701362
J Natl Compr Canc Netw. 2015 Aug;13(8):1012-39
pubmed: 26285247
BMC Cancer. 2012 Jun 18;12:251
pubmed: 22708709
Int J Radiat Oncol Biol Phys. 2001 Nov 1;51(3):691-8
pubmed: 11597810
Pract Radiat Oncol. 2017 Mar - Apr;7(2):73-79
pubmed: 27866865

Auteurs

Tobias Forster (T)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany.

Cornelia Jäkel (C)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany.
Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.

Sati Akbaba (S)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany.

David Krug (D)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Department of Radiation Oncology, University Hospital Schleswig Holstein, Kiel, Germany.

Robert Krempien (R)

Department of Radiation Oncology, Helios Hospital Berlin-Buch, Berlin, Germany.

Matthias Uhl (M)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany.

Matthias Felix Häfner (MF)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany.

Laila König (L)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany.

Stefan Alexander Koerber (SA)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany.

Semi Harrabi (S)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany.

Denise Bernhardt (D)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany.

Rouven Behnisch (R)

Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany.

Johannes Krisam (J)

Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany.

Andre Hennigs (A)

Department of Gynecology and Obstetrics, Heidelberg University, 69115, Heidelberg, Germany.

Christof Sohn (C)

Department of Gynecology and Obstetrics, Heidelberg University, 69115, Heidelberg, Germany.

Jörg Heil (J)

Department of Gynecology and Obstetrics, Heidelberg University, 69115, Heidelberg, Germany.

Jürgen Debus (J)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany.
Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
German Cancer Consortium (DKTK), partner site Heidelberg, Heidelberg, Germany.

Juliane Hörner-Rieber (J)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. juliane.hoerner-rieber@med.uni-heidelberg.de.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany. juliane.hoerner-rieber@med.uni-heidelberg.de.
National Center for Tumor Diseases (NCT), Heidelberg, Germany. juliane.hoerner-rieber@med.uni-heidelberg.de.
Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany. juliane.hoerner-rieber@med.uni-heidelberg.de.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH