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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00470236
Registration number
NCT00470236
Ethics application status
Date submitted
3/05/2007
Date registered
7/05/2007
Date last updated
22/03/2023
Titles & IDs
Public title
Radiation Doses and Fractionation Schedules in Non-low Risk Ductal Carcinoma In Situ (DCIS) of the Breast
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Scientific title
A Randomised Phase III Study of Radiation Doses and Fractionation Schedules in Non-low Risk Ductal Carcinoma In Situ (DCIS) of the Breast
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Secondary ID [1]
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NHMRC 454390
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Secondary ID [2]
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TROG 07.01
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Universal Trial Number (UTN)
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Trial acronym
DCIS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Carcinoma, Ductal, Breast
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Condition category
Condition code
Cancer
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Non melanoma skin cancer
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Cancer
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Kidney
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Cancer
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Cervical (cervix)
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Cancer
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Breast
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Cancer
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Other cancer types
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - Standard WB fractionation
Treatment: Other - Shorter WB fractionation
Treatment: Other - Standard WB fractionation+Boost
Treatment: Other - Shorter WB fractionation + Boost
Active comparator: Arm 1 (Standard WB Fractionation) - Whole Breast RT alone - Standard fractionation schedule (50GY/25 Fractions/35days)
Experimental: Arm 2 (Shorter WB Fractionation) - Whole Breast RT alone - Shorter fractionation schedule (42.5 Gy/16 fractions/22 days)
Active comparator: Arm 3 (Standard WB fractionation+Boost) - Whole Breast RT + tumor bed boost - Standard fractionation schedule (50 Gy/25 fractions/35 days; Boost 16 Gy/8 fractions/10 days)
Experimental: Arm 4 (Shorter WB fractionation + Boost) - Whole breast RT + tumour bed boost - Shorter fractionation schedule (42.5 Gy/16 fractions/22 days; Boost 16 Gy/8 fractions/10 days)
Treatment: Other: Standard WB fractionation
A total dose of 50 Gy in 25 fractions in 2-Gy daily fractions, 5 fractions per week (at least 9 fractions per fortnight).
Treatment: Other: Shorter WB fractionation
A total dose of 42.5 Gy in 16 fractions in 2.656-Gy daily fractions, 5 fractions per week (at least 9 fractions per fortnight).
Treatment: Other: Standard WB fractionation+Boost
Whole Breast: A total dose of 50 Gy in 25 fractions in 2-Gy daily fractions, 5 fractions per week (at least 9 fractions per fortnight).
Tumour bed: A total dose of 10 Gy in 5 fractions in 2-Gy daily fractions, 5 fractions per week.
Treatment: Other: Shorter WB fractionation + Boost
Whole breast: A total dose of 42.5 Gy in 16 fractions in 2.656-Gy daily fractions, 5 fractions per week (at least 9 fractions per fortnight).
Tumour bed: A total dose of 10 Gy in 4 fractions in 2.5-Gy daily fractions, 4 fractions per week.
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Intervention code [1]
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Treatment: Other
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Time to local recurrence, measured from the date of randomization to the date of first evidence of local recurrence.
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Assessment method [1]
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Timepoint [1]
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Main analysis after all patients have completed 5 years of follow-up. Updated analysis after 10 years of follow-up.
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Secondary outcome [1]
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Overall survival
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Assessment method [1]
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Timepoint [1]
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Measured from the date of randomization to the date of death from any cause. Main analysis of secondary outcomes after all patients have completed 5 years of follow-up. Updated analysis after 10 years of follow-up.
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Secondary outcome [2]
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Time to disease recurrence
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Assessment method [2]
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Timepoint [2]
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Measured from the date of randomization to the date of first evidence of recurrent disease. Main analysis of secondary outcomes after all patients have completed 5 years of follow-up. Updated analysis after 10 years of follow-up.
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Secondary outcome [3]
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Cosmetic Outcome
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Assessment method [3]
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Timepoint [3]
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Cosmetic assessment will take place at baseline, 12, 36 and 60 months post RT.
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Secondary outcome [4]
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Radiation toxicity
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Assessment method [4]
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Timepoint [4]
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Assessed at baseline, last week of RT, 3, 6, and 12 months post RT and then yearly until year 10.
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Secondary outcome [5]
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Quality of Life change
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Assessment method [5]
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Timepoint [5]
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Assessed at baseline, last week of RT, 6, 12, 24, 60 & 120 months post RT.
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Eligibility
Key inclusion criteria
Patients must fulfill all of the following criteria for admission to study:
* Women = 18 years.
* Histologically proven DCIS of the breast without an invasive component.
* Bilateral mammograms performed within 6 months prior to randomization.
* Clinically node-negative.
* Treated by breast conserving surgery (primary excision or re-excision) with complete microscopic excision and clear radial margins of =1 mm* (*Patients with superficial or deep resection margin of <1 mm are eligible if surgery has removed all of the intervening breast tissue from the subcutaneous tissue to the pectoralis fascia).
* Women who are at high risk of local recurrence due to:
* Age < 50 years; OR
* Age = 50 years plus at least one of the following:
* Symptomatic presentation
* Palpable tumour
* Multifocal disease
* Microscopic tumour size = 1.5 cm in maximum dimension
* Intermediate or high nuclear grade
* Central necrosis
* Comedo histology
* Radial* surgical resection margin < 10 mm. (*Patients with superficial or deep resection margin of < 10 mm are eligible if surgery has not removed all of the intervening breast tissue from the subcutaneous tissue to the pectoralis fascia.)
* Assessed by surgeon and radiation oncologist to be suitable for breast conserving therapy including whole breast RT.
* Ability to tolerate protocol treatment.
* Protocol RT should preferably commence within 8 weeks but must commence no later than 12 weeks from the last surgical procedure.
* ECOG performance status 0, 1 or 2.
* Patient's life expectancy > 5 years.
* Availability for long-term follow-up.
* Written informed consent.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients who fulfill any of the following criteria are not eligible for admission to study:
* Multicentric disease or extensive microcalcifications that could not be completely excised by breast conserving surgery with radial margins of =1 mm*.
*Patients with superficial and/or deep margin of <1 mm are eligible if surgery has removed all of the intervening breast tissue from the subcutaneous tissue to the pectoralis fascia.
* Presence of tumour cells in lymph nodes detected using H&E or immunohistochemical examination (if lymph node biopsy or dissection has been performed).
* Locally recurrent breast cancer.
* Previous DCIS or invasive cancer of the contralateral breast.
* Bilateral DCIS of the breasts
* Synchronous invasive carcinoma of the contralateral breast
* Other concurrent or previous malignancies except:
* Non-melanomatous skin cancer;
* Carcinoma in situ of the cervix or endometrium; and
* Invasive carcinoma of the cervix, endometrium, colon, thyroid and melanoma treated at least five years prior to study admission without disease recurrence.
* Serious non-malignant disease that precludes definitive surgical or radiation treatment (e.g., scleroderma, systemic lupus erythematosus, cardiovascular/pulmonary/renal disease).
* ECOG performance status = 3.
* Women who are pregnant or lactating.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/06/2007
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/06/2024
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Actual
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Sample size
Target
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Accrual to date
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Final
1608
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,TAS,VIC,WA
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Recruitment hospital [1]
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Campbelltown Hospital - Campbelltown
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Nepean Cancer Care Centre - Kingswood
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St George Hospital - Kogarah
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Liverpool Hospital - Liverpool
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Royal North Shore Hospital - St Leonards
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Riverina Cancer Care Centre - Wagga Wagga
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Calvary Mater Newcastle - Waratah
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Westmead Hospital - Wentworthville
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Premion - Wesley - Auchenflower
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Royal Brisbane and Women's Hospital - Brisbane
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Princess Alexandra Hospital - Brisbane
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Genesis Cancer Care (previously Premion) - Nambour - Nambour
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Radiation Oncology - Mater Centre - South Brisbane
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Toowoomba Cancer Research Centre - Toowoomba
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North Queensland Oncology Service - Townsville
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Genesis Cancer Care (previously Premion) - Tugun - Tugun
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Royal Adelaide Hospital - Adelaide
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Royal Hobart Hospital - Hobart
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Launceston General Hospital - Launceston
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Barwon Health - Andrew Love Cancer Care Centre, Geelong Hospital - Geelong
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Peter MacCallum Cancer Centre - Melbourne
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Austin Hospital - Melbourne
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William Buckland Radiotherapy Centre, Alfred Hospital - Melbourne
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Sir Charles Gardiner Hospital - Nedlands
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Royal Perth Hospital - Perth
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Perth Radiation Oncology - Perth
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Recruitment postcode(s) [1]
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2560 - Campbelltown
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Recruitment postcode(s) [2]
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- Kingswood
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2217 - Kogarah
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2170 - Liverpool
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2065 - St Leonards
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2650 - Wagga Wagga
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Recruitment postcode(s) [7]
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2298 - Waratah
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Recruitment postcode(s) [8]
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2145 - Wentworthville
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4006 - Auchenflower
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4006 - Brisbane
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Recruitment postcode(s) [11]
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4102 - Brisbane
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Recruitment postcode(s) [12]
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- Nambour
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4101 - South Brisbane
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- Toowoomba
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4810 - Townsville
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4224 - Tugun
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5000 - Adelaide
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7000 - Hobart
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7250 - Launceston
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3220 - Geelong
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3002 - Melbourne
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3084 - Melbourne
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3181 - Melbourne
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6009 - Nedlands
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6001 - Perth
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- Perth
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Aalst
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Wolverhampton
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Funding & Sponsors
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Trans Tasman Radiation Oncology Group
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Other
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Breast International Group
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Other
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NCIC Clinical Trials Group
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Other
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Cancer Trials Ireland
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Other
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Borstkanker Onderzoek Groep
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Other
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ETOP IBCSG Partners Foundation
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Other
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Scottish Cancer Trials Breast Group
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Other
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European Organisation for Research and Treatment of Cancer - EORTC
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Summary
Brief summary
Hypotheses: 1. The addition of tumour bed boost after BCS in women with non-low risk DCIS reduces the risk of local recurrence (invasive or intraductal recurrence in the ipsilateral breast). 2. The risk of local recurrence in the shorter fractionation arm is not worse than that for the standard fractionation arm. 3. A molecular signature predictive of invasive recurrence of DCIS will be detectable and the molecular signature may eventually have clinical utility for therapy individualization. Overall Objectives: 1. To improve the outcome of women with non-low risk DCIS treated with breast conserving therapy. 2. To individualize treatment selection for women with DCIS to achieve long term disease control with minimal toxicity.
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Trial website
https://clinicaltrials.gov/study/NCT00470236
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Trial related presentations / publications
Chua BH, Link EK, Kunkler IH, Whelan TJ, Westenberg AH, Gruber G, Bryant G, Ahern V, Purohit K, Graham PH, Akra M, McArdle O, O'Brien P, Harvey JA, Kirkove C, Maduro JH, Campbell ID, Delaney GP, Martin JD, Vu TTT, Muanza TM, Neal A, Olivotto IA; BIG 3-07/TROG 07.01 trial investigators. Radiation doses and fractionation schedules in non-low-risk ductal carcinoma in situ in the breast (BIG 3-07/TROG 07.01): a randomised, factorial, multicentre, open-label, phase 3 study. Lancet. 2022 Aug 6;400(10350):431-440. doi: 10.1016/S0140-6736(22)01246-6. King MT, Link EK, Whelan TJ, Olivotto IA, Kunkler I, Westenberg AH, Gruber G, Schofield P, Chua BH; BIG 3-07/TROG 07.01 trial investigators. Quality of life after breast-conserving therapy and adjuvant radiotherapy for non-low-risk ductal carcinoma in situ (BIG 3-07/TROG 07.01): 2-year results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2020 May;21(5):685-698. doi: 10.1016/S1470-2045(20)30085-1. Epub 2020 Mar 20.
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Public notes
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Contacts
Principal investigator
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Boon Chua
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Prince of Wales Hospital Randwick
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Results not provided in
https://clinicaltrials.gov/study/NCT00470236
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