Breast CancerPhase 3NCT01349322
Higher Per Daily Treatment-Dose Radiation Therapy or Standard Per Daily Treatment Radiation Therapy in Treating Patients With Early-Stage Breast Cancer That Was Removed by Surgery
A Phase 3 study testing Standard fractionation whole breast irradiation, Hypofractionated whole breast irradiation and Concurrent boost in people with Breast Cancer, run by Radiation Therapy Oncology Group at 415 sites in 8 countries.
Trial summary
RATIONALE: It is not yet know whether higher per daily radiation therapy is equally as effective as standard per daily radiation therapy in treating breast cancer. PURPOSE: This randomized phase III trial studies how well an accelerated course of higher per daily radiation therapy with concomitant boost works compared… Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Breast Cancer
- What is being tested?
- Standard fractionation whole breast irradiation, Hypofractionated whole breast irradiation and Concurrent boost
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 2,354 participants
- Where
- 415 sitesin 8 countries
- Study dates
- 24 May 2011to 25 Jan 2022
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Pathologically proven diagnosis of breast cancer resected by lumpectomy and whole breast irradiation with boost without regional nodal irradiation planned
- The patient must be female
- The patient must meet at least one of the three following criteria:
- A. Pathological stage I, II Breast Cancer AND at least one of the following:
- Age < 50 years or
- Positive axillary nodes or
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- Lymphovascular space invasion or
- 2 or more close resection margins (> 0 mm to ≤ 2 mm) or
- 1 close resection margin and extensive intraductal component (EIC) [Per College of American Pathologist (CAP) Recommendation] or
- Focally positive resection margins or
- Non-hormone sensitive breast cancer (estrogen receptor (ER)- and progesterone receptor(PR)-negative) or
- Grade III histology or
- Oncotype recurrence score > 25 or
- B. Pathological stage 0 breast cancer with nuclear grade 3 ductal carcinoma in situ (DCIS) and patient age <50 years or
- C. Post-neoadjuvant pathological 0, I, II breast cancer resected by lumpectomy after neoadjuvant systemic therapy
- Study entry must be within 50 days from whichever comes later: last surgery (breast or axilla) or last chemotherapy. The day of surgery is Day "0".
- If multifocal breast cancer, then it must have been resected through a single lumpectomy incision with negative margins
- Breast-conserving surgery with margins defined as follows: (also see 3.1.3 for eligibility)
- Negative margins defined as no tumor at the resected specimen edge.
- Close resection margins > 0 mm to ≤ 2 mm. as follows:
- One close resection margin and EIC (per College of American Pathologist (CAP) Recommendation)
- 2 or more close resection margins.
- A focally positive resection margin
- For invasive breast cancer the axilla must be staged by one of the following:
- Sentinel node biopsy alone, if sentinel node is negative, i.e. any of the following:
- pN0: no regional lymph node metastasis identified histologically,
- pN0(i-): pN0 and immunohistochemical (IHC) negative, or
- pN0(i+): pN0 and IHc positive;
- Sentinel node biopsy alone, OR followed by axillary node dissection per investigator discretion, for clinically node negative patients as described below:
- microscopic sentinel node positive (pN1mic)
- one or two sentinel nodes positive (pN1) without extracapsular extension
- negative sentinel node biopsy after neoadjuvant chemotherapy
- Axillary node dissection is required following sentinel node (SN) biopsy with a minimum total of 6 axillary nodes if any of the following exist:
- for > 2 positive SN
- any positive SN biopsy after neoadjuvant chemotherapy
- for clinically (by either imaging or examination) T3 disease
- for extracapsular extension
- Axillary dissection alone (with a minimum of 6 axillary nodes)
- Age ≥ 18
- CT-imaging of the ipsilateral breast within 28 days prior to study entry for the radiation treatment planning. Must be able to delineate on CT scan the extent of the target lumpectomy cavity for boost
- Appropriate stage for protocol entry, including no clinical evidence for distant metastases, based upon the following minimum diagnostic workup:
- History/physical examination, including breast exam (inspection and palpation of the breasts) and documentation of weight and Zubrod Performance Status of 0-2 within 28 days prior to study entry;
- Right and left mammography within 90 days of diagnostic biopsy establishing diagnosis
- Patients must have had ER analysis performed on the primary breast tumor prior to study entry according to current American Society of Clinical Oncology (ASCO)/ College of American Pathologists (CAP) Guideline Recommendations for hormone receptor testing. If negative for ER, assessment of PR must also be performed according to current ASCO/CAP Guideline Recommendations for hormone receptor testing (http://www.asco.org)
- Complete blood count (CBC)/differential obtained within 14 days prior to study entry, with adequate bone marrow function defined as follows:
- Absolute neutrophil count (ANC) ≥ 1,800 cells/mm3
- Platelets ≥ 75,000 cells/mm3
- Hemoglobin ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve Hgb ≥ 8.0 g/dl is acceptable.)
- Women of childbearing potential must have a negative urine or serum pregnancy test within 14 days of study entry
- Women of childbearing potential must be non-pregnant and non-lactating and willing to use medically acceptable form of contraception during radiation therapy
- Patient must provide study specific informed consent prior to study entry
- Breast implants allowed
Who cannot join
- American Joint Committee on Cancer (AJCC) pathologic T4, N2 or N3, M1 pathologic stages III or IV breast cancer
- Treatment plan that includes regional node irradiation
- Prior invasive non-breast malignancy (except non-melanomatous skin cancer, carcinoma in situ of the cervix) unless disease free for a minimum of 5 years prior to study entry
- Prior invasive or in-situ carcinoma of the breast [-prior lobular carcinoma in situ (LCIS) is eligible]
- Two or more breast cancers not resectable through a single lumpectomy incision
- Bilateral breast cancer
Show all 26Show fewer
- DCIS only (without an invasive component) and age ≥ 50 years
- DCIS nuclear grade 1 or 2 only (without an invasive component) and age < 50 years
- Invasive breast cancer and low risk for 5-year in breast recurrence after lumpectomy with negative margins that does not meet one of the eligibility factors in 3.1.3.
- Unable to delineate on CT scan the extent of the target lumpectomy cavity for boost (Placement of surgical clips to assist in treatment planning of the boost is strongly recommended, see Section 6.4.2 for details)
- Suspicious unresected microcalcification, densities, or palpable abnormalities (in the ipsilateral or contralateral breast) unless biopsied and found to be benign
- Non-epithelial breast malignancies such as sarcoma or lymphoma
- Paget's disease of the nipple
- Male breast cancer
- Prior radiotherapy to the breast or prior radiation to the region of the ipsilateral breast that would result in overlap of radiation therapy fields
- Intention to administer concurrent chemotherapy for current breast cancer.
- Severe, active co-morbidity, defined as follows:
- Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months
- Transmural myocardial infarction within the last 6 months
- Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration;
- Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy within 30 days before registration;
- Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for liver function and coagulation parameters are not required for entry into this protocol
- Acquired Immune Deficiency Syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; note, however, that HIV testing is not required for entry into this protocol. The need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive
- Pregnancy or women of childbearing potential who are sexually active and not willing/able to use medically acceptable forms of contraception
- Active systemic lupus, erythematosus, or any history of scleroderma, dermatomyositis with active rash
- Medical, psychiatric or other condition that would prevent the patient from receiving the protocol therapy or providing informed consent
Trial locations and contacts
415 sites in 8 countries.
329 sites in 8 countries
United States300 sites
Jefferson Abington Hospital
Abington, Pennsylvania, 19001
Summa Health System - Akron Campus
Akron, Ohio, 44304
Cleveland Clinic Akron General
Akron, Ohio, 44307
New York Oncology Hematology PC - Albany
Albany, New York, 12206
Saint Peter's Health Partners
Albany, New York, 12208
Mayo Clinic Health System in Albert Lea
Albert Lea, Minnesota, 56007
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87102
Inova Alexandria Hospital
Alexandria, Virginia, 22304
Saint Vincent Anderson Regional Hospital/Cancer Center
Anderson, Indiana, 46016
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, 48109
Anne Arundel Medical Center
Annapolis, Maryland, 21401
Langlade Hospital and Cancer Center
Antigo, Wisconsin, 54409
ThedaCare Regional Medical Center - Appleton
Appleton, Wisconsin, 54911
Texas Oncology-Arlington South
Arlington, Texas, 76014
Grady Health System
Atlanta, Georgia, 30303
Emory University Hospital Midtown
Atlanta, Georgia, 30308
Piedmont Hospital
Atlanta, Georgia, 30309
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
Emory Saint Joseph's Hospital
Atlanta, Georgia, 30342
Northside Hospital
Atlanta, Georgia, 30342
John Fitzgerald Kennedy Medical Center
Atlantis, Florida, 33462
Sutter Cancer Centers Radiation Oncology Services-Auburn
Auburn, California, 95603
University of Colorado Hospital
Aurora, Colorado, 80045
Rush - Copley Medical Center
Aurora, Illinois, 60504
Texas Oncology-Austin Midtown
Austin, Texas, 78705
Texas Oncology - South Austin Cancer Center
Austin, Texas, 78745
IU Health West Hospital
Avon, Indiana, 46123
University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland, 21201
Greater Baltimore Medical Center
Baltimore, Maryland, 21204
Saint Agnes Hospital
Baltimore, Maryland, 21229
Summa Health System - Barberton Campus
Barberton, Ohio, 44203
Memorial Sloan Kettering Basking Ridge
Basking Ridge, New Jersey, 07920
UHHS-Chagrin Highlands Medical Center
Beachwood, Ohio, 44122
UPMC-Heritage Valley Health System Beaver
Beaver, Pennsylvania, 15009
Texas Oncology Bedford
Bedford, Texas, 76022
Beloit Memorial Hospital
Beloit, Wisconsin, 53511
Sanford Joe Lueken Cancer Center
Bemidji, Minnesota, 56601
Walter Reed National Military Medical Center
Bethesda, Maryland, 20889-5600
Billings Clinic Cancer Center
Billings, Montana, 59101
University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233
The Kirklin Clinic at Acton Road
Birmingham, Alabama, 35243
Sanford Bismarck Medical Center
Bismarck, North Dakota, 58501
Prisma Health Cancer Institute - Spartanburg
Boiling Springs, South Carolina, 29316
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, 02114
Boston Medical Center
Boston, Massachusetts, 02118
Harrison Medical Center
Bremerton, Washington, 98310
Ocean Medical Center
Brick, New Jersey, 08724
Bryn Mawr Hospital
Bryn Mawr, Pennsylvania, 19010
Roswell Park Cancer Institute
Buffalo, New York, 14263
Sutter Cancer Centers Radiation Oncology Services-Cameron Park
Cameron Park, California, 95682
Sands Cancer Center
Canandiaqua, New York, 14424
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Mercy San Juan Medical Center
Carmichael, California, 95608
Geauga Hospital
Chardon, Ohio, 44024
Medical University of South Carolina
Charleston, South Carolina, 29425
University of Virginia Cancer Center
Charlottesville, Virginia, 22908
Saint Luke's Hospital
Chesterfield, Missouri, 63017
Northwestern University
Chicago, Illinois, 60611
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
Advocate Illinois Masonic Medical Center
Chicago, Illinois, 60657
Enloe Medical Center
Chico, California, 95926
Adena Regional Medical Center
Chillicothe, Ohio, 45601
The Christ Hospital
Cincinnati, Ohio, 45219
University of Cincinnati Cancer Center-UC Medical Center
Cincinnati, Ohio, 45219
Siteman Cancer Center at Saint Peters Hospital
City of Saint Peters, Missouri, 63376
Clackamas Radiation Oncology Center
Clackamas, Oregon, 97015
GenesisCare USA - Clarkston
Clarkston, Michigan, 48346
Case Western Reserve University
Cleveland, Ohio, 44106
Cleveland Clinic Cancer Center/Fairview Hospital
Cleveland, Ohio, 44111
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
Henry Ford Macomb Hospital-Clinton Township
Clinton Township, Michigan, 48038
Mercy Cancer Center-West Lakes
Clive, Iowa, 50325
Penrose-Saint Francis Healthcare
Colorado Springs, Colorado, 80907
Central Maryland Radiation Oncology in Howard County
Columbia, Maryland, 21044
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Memorial Sloan Kettering Commack
Commack, New York, 11725
Mary Imogene Bassett Hospital
Cooperstown, New York, 13326
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri, 63141
Northside Hospital-Forsyth
Cumming, Georgia, 30041
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
Mass General/North Shore Cancer Center
Danvers, Massachusetts, 01923
Geisinger Medical Center
Danville, Pennsylvania, 17822
Florida Hospital Memorial Medical Center
Daytona Beach, Florida, 32117
Decatur Memorial Hospital
Decatur, Illinois, 62526
UM Sylvester Comprehensive Cancer Center at Deerfield Beach
Deerfield Beach, Florida, 33442
Texas Oncology - Denison Cancer Center
Denison, Texas, 75020
Texas Oncology-Denton South
Denton, Texas, 76201
Porter Adventist Hospital
Denver, Colorado, 80210
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
Wayne State University/Karmanos Cancer Institute
Detroit, Michigan, 48201
Henry Ford Hospital
Detroit, Michigan, 48202
Ascension Saint John Hospital
Detroit, Michigan, 48236
Delaware County Memorial Hospital
Drexel Hill, Pennsylvania, 19026
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
Epic Care-Dublin
Dublin, California, 94568
Finley Hospital
Dubuque, Iowa, 52001
Miller-Dwan Hospital
Duluth, Minnesota, 55805
Northeast Radiation Oncology Center
Dunmore, Pennsylvania, 18512
Duke University Medical Center
Durham, North Carolina, 27710
Pocono Medical Center
East Stroudsburg, Pennsylvania, 18301
Hematology Oncology Associates of Central New York-East Syracuse
East Syracuse, New York, 13057
Mayo Clinic Health System Eau Claire Hospital-Luther Campus
Eau Claire, Wisconsin, 54703
Shaw Cancer Center
Edwards, Colorado, 81632
21st Century Oncology - El Segundo
El Segundo, California, 90245
UPMC Hillman Cancer Center Erie
Erie, Pennsylvania, 16505
Willamette Valley Cancer Center
Eugene, Oregon, 97401
Inova Fairfax Hospital
Falls Church, Virginia, 22042
Sanford Roger Maris Cancer Center
Fargo, North Dakota, 58122
GenesisCare USA - Farmington Hills
Farmington Hills, Michigan, 48334
Weisberg Cancer Treatment Center
Farmington Hills, Michigan, 48334
Beaumont Hospital - Farmington Hills
Farmington Hills, Michigan, 48336
Saint Francis Hospital
Federal Way, Washington, 98003
Augusta Health Center for Cancer and Blood Disorders
Fishersville, Virginia, 22939
McLaren Cancer Institute-Flint
Flint, Michigan, 48532
Saint Agnes Hospital/Agnesian Cancer Center
Fond du Lac, Wisconsin, 54935
Brooke Army Medical Center
Fort Sam Houston, Texas, 78234
21st Century Oncology - Fort Walton Beach
Fort Walton Beach, Florida, 32547
Texas Oncology - Fort Worth Cancer Center
Fort Worth, Texas, 76104
Freeport Memorial Hospital/Leonard C Ferguson Cancer Center
Freeport, Illinois, 61032
Fox Chase Cancer Center Buckingham
Furlong, Pennsylvania, 18925
University of Florida Health Science Center - Gainesville
Gainesville, Florida, 32610
Adams Cancer Center
Gettysburg, Pennsylvania, 17325
UM Baltimore Washington Medical Center/Tate Cancer Center
Glen Burnie, Maryland, 21061
Goshen Center for Cancer Care
Goshen, Indiana, 46526
Altru Cancer Center
Grand Forks, North Dakota, 58201
Mercy Health Saint Mary's
Grand Rapids, Michigan, 49503
Spectrum Health at Butterworth Campus
Grand Rapids, Michigan, 49503
Three Rivers Community Hospital
Grants Pass, Oregon, 97527
Benefis Healthcare- Sletten Cancer Institute
Great Falls, Montana, 59405
Bellin Memorial Hospital
Green Bay, Wisconsin, 54301
Saint Vincent Hospital Cancer Center Green Bay
Green Bay, Wisconsin, 54301
Saint Vincent Hospital Cancer Center at Saint Mary's
Green Bay, Wisconsin, 54303
Aurora BayCare Medical Center
Green Bay, Wisconsin, 54311
UPMC Cancer Centers - Arnold Palmer Pavilion
Greensburg, Pennsylvania, 15601
East Carolina University
Greenville, North Carolina, 27834
Greenville Health System Cancer Institute-Andrews
Greenville, South Carolina, 29601
Prisma Health Cancer Institute - Faris
Greenville, South Carolina, 29605
Prisma Health Cancer Institute - Eastside
Greenville, South Carolina, 29615
Prisma Health Cancer Institute - Greer
Greer, South Carolina, 29650
Gibbs Cancer Center-Pelham
Greer, South Carolina, 29651
Sentara Cancer Institute at Sentara CarePlex Hospital
Hampton, Virginia, 23666
Cherry Tree Cancer Center
Hanover, Pennsylvania, 17331
Sentara Rockingham Memorial Hospital Hahn Cancer Center
Harrisonburg, Virginia, 22801
Hartford Hospital
Hartford, Connecticut, 06102
Penn State Milton S Hershey Medical Center
Hershey, Pennsylvania, 17033-0850
The Radiation Oncology Center-Hilton Head/Bluffton
Hilton Head Island, South Carolina, 29926
Queen's Medical Center
Honolulu, Hawaii, 96813
CHI Saint Vincent Cancer Center Hot Springs
Hot Springs, Arkansas, 71913
Memorial Hermann Memorial City Medical Center
Houston, Texas, 77024
Edwards Comprehensive Cancer Center
Huntington, West Virginia, 25701
Cleveland Clinic Cancer Center Independence
Independence, Ohio, 44131
Indiana University/Melvin and Bren Simon Cancer Center
Indianapolis, Indiana, 46202
IU Health Methodist Hospital
Indianapolis, Indiana, 46202
Community Cancer Center East
Indianapolis, Indiana, 46219
Community Cancer Center North
Indianapolis, Indiana, 46256
Baylor Medical Center at Irving
Irving, Texas, 75061
Cayuga Medical Center
Ithaca, New York, 14850
Baptist MD Anderson Cancer Center
Jacksonville, Florida, 32207
Integrated Community Oncology Network-Southside Cancer Center
Jacksonville, Florida, 32207
University of Florida Health Science Center - Jacksonville
Jacksonville, Florida, 32209
Mayo Clinic in Florida
Jacksonville, Florida, 32224-9980
Baptist Medical Center South
Jacksonville, Florida, 32258
Integrated Community Oncology Network-Florida Cancer Center Beaches
Jacksonville Beach, Florida, 32250
UW Cancer Center Johnson Creek
Johnson Creek, Wisconsin, 53038
UPMC-Johnstown/John P. Murtha Regional Cancer Center
Johnstown, Pennsylvania, 15901
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
Kalispell Regional Medical Center
Kalispell, Montana, 59901
University of Kansas Cancer Center
Kansas City, Kansas, 66160
The University of Kansas Cancer Center-South
Kansas City, Missouri, 64131
University of Kansas Cancer Center - North
Kansas City, Missouri, 64154
Tri-Cities Cancer Center
Kennewick, Washington, 99336
Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
Mayo Clinic Health System-Franciscan Healthcare
La Crosse, Wisconsin, 54601
UC San Diego Moores Cancer Center
La Jolla, California, 92093
Northwell Health NCORP
Lake Success, New York, 11042
Northwell Health/Center for Advanced Medicine
Lake Success, New York, 11042
Lancaster General Hospital
Lancaster, Pennsylvania, 17602
Saint Mary Medical and Regional Cancer Center
Langhorne, Pennsylvania, 19047
Memorial Medical Center - Las Cruces
Las Cruces, New Mexico, 88011
Radiation Oncology Centers of Nevada Central
Las Vegas, Nevada, 89106
Comprehensive Cancer Centers of Nevada
Las Vegas, Nevada, 89148
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Dartmouth Hitchcock Medical Center
Lebanon, New Hampshire, 03756
University of Kansas Cancer Center - Lee's Summit
Lee's Summit, Missouri, 64064
Texas Oncology - Lewisville
Lewisville, Texas, 75067
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
Liberty Radiation Oncology Center
Liberty, Missouri, 64068
University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
Logan Regional Hospital
Logan, Utah, 84321
Monmouth Medical Center
Long Branch, New Jersey, 07740
Los Angeles County-USC Medical Center
Los Angeles, California, 90033
USC / Norris Comprehensive Cancer Center
Los Angeles, California, 90033
Cedars Sinai Medical Center
Los Angeles, California, 90048
UCLA / Jonsson Comprehensive Cancer Center
Los Angeles, California, 90095
McKee Medical Center
Loveland, Colorado, 80539
Lowell General Hospital
Lowell, Massachusetts, 01854
University of Wisconsin Hospital and Clinics
Madison, Wisconsin, 53792
Mayo Clinic Health Systems-Mankato
Mankato, Minnesota, 56001
Bay Area Medical Center
Marinette, Wisconsin, 54143
Hillcrest Hospital Cancer Center
Mayfield Heights, Ohio, 44124
Loyola University Medical Center
Maywood, Illinois, 60153
UPMC Cancer Center at UPMC McKeesport
McKeesport, Pennsylvania, 15132
Holy Redeemer Hospital and Medical Center
Meadowbrook, Pennsylvania, 19046
Providence Medford Medical Center
Medford, Oregon, 97504
Rogue Valley Medical Center
Medford, Oregon, 97504
Riddle Memorial Hospital
Media, Pennsylvania, 19063
Summa Health Medina Medical Center
Medina, Ohio, 44256
Froedtert Menomonee Falls Hospital
Menomonee Falls, Wisconsin, 53051
UH Seidman Cancer Center at Lake Health Mentor Campus
Mentor, Ohio, 44060
Ascension Columbia Saint Mary's Hospital Ozaukee
Mequon, Wisconsin, 53097
Jackson Memorial Hospital-Holtz Children's Hospital
Miami, Florida, 33136
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
UH Seidman Cancer Center at Southwest General Hospital
Middleburg Heights, Ohio, 44130
Ascension Columbia Saint Mary's Hospital - Milwaukee
Milwaukee, Wisconsin, 53211
Aurora Saint Luke's Medical Center
Milwaukee, Wisconsin, 53215
Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
Michiana Hematology Oncology PC-Mishawaka
Mishawaka, Indiana, 46545
KCC Radiation Oncology at Monroe Cancer Center
Monroe, Michigan, 48162
Intercommunity Cancer Center
Monroeville, Pennsylvania, 15146
UPMC-Coraopolis/Heritage Valley Radiation Oncology
Moon Township, Pennsylvania, 15108
The Coleman Radiation Center-Carteret General Hospital
Morehead City, North Carolina, 28557
West Virginia University Healthcare
Morgantown, West Virginia, 26506
Morristown Medical Center
Morristown, New Jersey, 07960
Virtua Memorial
Mount Holly, New Jersey, 08060
Skagit Valley Hospital
Mount Vernon, Washington, 98274
IU Health Ball Memorial Hospital
Muncie, Indiana, 47303
Intermountain Medical Center
Murray, Utah, 84107
Allegheny Valley Hospital
Natrona Heights, Pennsylvania, 15065
Jersey Shore Medical Center
Neptune City, New Jersey, 07753
CarolinaEast Medical Center
New Bern, North Carolina, 28561
Saint Peter's University Hospital
New Brunswick, New Jersey, 08901
UPMC Jameson
New Castle, Pennsylvania, 16105
Long Island Jewish Medical Center
New Hyde Park, New York, 11040
UC Comprehensive Cancer Center at Silver Cross
New Lenox, Illinois, 60451
Tulane University Health Sciences Center
New Orleans, Louisiana, 70112
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York, New York, 10032
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
Newton-Wellesley Hospital
Newton, Massachusetts, 02462
Sentara Norfolk General Hospital
Norfolk, Virginia, 23507
Carle Cancer Institute Normal
Normal, Illinois, 61761
Kaiser Permanente Oakland-Broadway
Oakland, California, 94611
West Texas Cancer Center
Odessa, Texas, 79761
McKay-Dee Hospital Center
Ogden, Utah, 84403
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Nebraska Methodist Hospital
Omaha, Nebraska, 68114
University of Nebraska Medical Center
Omaha, Nebraska, 68198
21st Century Oncology-Orange Park
Orange Park, Florida, 32073
AdventHealth Orlando
Orlando, Florida, 32803
Orlando Health Cancer Institute
Orlando, Florida, 32806
University of Kansas Cancer Center-Overland Park
Overland Park, Kansas, 66210
Owensboro Health Mitchell Memorial Cancer Center
Owensboro, Kentucky, 42303
Cancer Center of Putnam
Palatka, Florida, 32177
Paoli Memorial Hospital
Paoli, Pennsylvania, 19301
Advocate Lutheran General Hospital
Park Ridge, Illinois, 60068
University Hospitals Parma Medical Center
Parma, Ohio, 44129
Singing River Hospital
Pascagoula, Mississippi, 39581
Capital Health Medical Center-Hopewell
Pennington, New Jersey, 08534
OSF Saint Francis Radiation Oncology at Peoria Cancer Center
Peoria, Illinois, 61615
OSF Saint Francis Medical Center
Peoria, Illinois, 61637
McLaren Cancer Institute-Northern Michigan
Petoskey, Michigan, 49770
University of Pennsylvania/Abramson Cancer Center
Philadelphia, Pennsylvania, 19104
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
Fox Chase Cancer Center
Philadelphia, Pennsylvania, 19111
FirstHealth of the Carolinas-Moore Regional Hospital
Pinehurst, North Carolina, 28374
Allegheny General Hospital
Pittsburgh, Pennsylvania, 15212
UPMC-Magee Womens Hospital
Pittsburgh, Pennsylvania, 15213
UPMC-Saint Margaret
Pittsburgh, Pennsylvania, 15215
UPMC-Shadyside Hospital
Pittsburgh, Pennsylvania, 15232
UPMC Jefferson Regional Radiation Oncology
Pittsburgh, Pennsylvania, 15236
UPMC-Passavant Hospital
Pittsburgh, Pennsylvania, 15237
UPMC-Saint Clair Hospital Cancer Center
Pittsburgh, Pennsylvania, 15243
Texas Oncology-Plano West
Plano, Texas, 75093
Saint Joseph Mercy Oakland
Pontiac, Michigan, 48341
Providence Portland Medical Center
Portland, Oregon, 97213
Naval Medical Center - Portsmouth
Portsmouth, Virginia, 23708-2197
Hudson Valley Oncology Associates
Poughkeepsie, New York, 12601
Kansas City NCI Community Oncology Research Program
Prairie Village, Kansas, 66208
Ascension All Saints Hospital
Racine, Wisconsin, 53405
Kaiser Permanente-Rancho Cordova Cancer Center
Rancho Cordova, California, 95670
Rapid City Regional Hospital
Rapid City, South Dakota, 57701
University Hospitals Portage Medical Center
Ravenna, Ohio, 44266
Penn State Health Saint Joseph Medical Center
Reading, Pennsylvania, 19605
Riverview Medical Center/Booker Cancer Center
Red Bank, New Jersey, 07701
Renown Regional Medical Center
Reno, Nevada, 89502
Saint Mary's Regional Medical Center
Reno, Nevada, 89503
Virginia Commonwealth University/Massey Cancer Center
Richmond, Virginia, 23298
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
Wilmot Cancer Institute Radiation Oncology at Greece
Rochester, New York, 14606
Highland Hospital
Rochester, New York, 14620
Rochester General Hospital
Rochester, New York, 14621
University of Rochester
Rochester, New York, 14642
Swedish American Hospital
Rockford, Illinois, 61104
SwedishAmerican Regional Cancer Center/ACT
Rockford, Illinois, 61114
Rohnert Park Cancer Center
Rohnert Park, California, 94928
Sutter Cancer Centers Radiation Oncology Services-Roseville
Roseville, California, 95661
The Permanente Medical Group-Roseville Radiation Oncology
Roseville, California, 95678
Texas Oncology-Seton Williamson
Round Rock, Texas, 78665
Texas Oncology - Round Rock Cancer Center
Round Rock, Texas, 78681
Canada20 sites
Cross Cancer Institute
Edmonton, Alberta, T6G 1Z2
Grand River Regional Cancer Centre at Grand River Hospital
Kitchener, Ontario, N2G 1G3
Hopital de la Cite-de-la-Sante
Laval, Quebec, H7M 3L9
London Regional Cancer Program
London, Ontario, N6A 4L6
CIUSSSEMTL-Hopital Maisonneuve-Rosemont
Montreal, Quebec, H1T 2M4
CHUM - Hopital Notre-Dame
Montreal, Quebec, H2L 4M1
McGill University Department of Oncology
Montreal, Quebec, H2W 1S6
CHUM - Centre Hospitalier de l'Universite de Montreal
Montreal, Quebec, H2X 3E4
The Research Institute of the McGill University Health Centre (MUHC)
Montreal, Quebec, H3H 2R9
Stronach Regional Health Centre at Southlake
Newmarket, Ontario, L3Y 2P9
Ottawa Hospital and Cancer Center-General Campus
Ottawa, Ontario, K1H 8L6
Ottawa Hospital-Civic Campus
Ottawa, Ontario, K1Y 4E9
Irving Greenberg Family Cancer Centre
Ottawa, Ontario, K2H 8P4
CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ)
Québec, Quebec, G1R 2J6
Allan Blair Cancer Centre
Regina, Saskatchewan, S4T 7T1
Atlantic Health Sciences Corporation-Saint John Regional Hospital
Saint John, New Brunswick, E2L 4L2
Centre Hospitalier Universitaire de Sherbrooke-Fleurimont
Sherbrooke, Quebec, J1H 5N4
BCCA-Vancouver Cancer Centre
Vancouver, British Columbia, V5Z 4E6
Windsor Regional Cancer Centre
Windsor, Ontario, N8W 2X3
CancerCare Manitoba
Winnipeg, Manitoba, R3E 0V9
Israel2 sites
Rabin Medical Center
Petah Tikva, 49100
Chaim Sheba Medical Center
Tel HaShomer, 52621
Singapore2 sites
National University Hospital Singapore
Singapore, 119074
National Cancer Centre Singapore
Singapore, 169610
South Korea2 sites
National Cancer Center-Korea
Goyang-si, Gyeonggi-do, 410-769
Yonsei University Health System-Severance Hospital
Seoul, 120-752
About this study
Official title: A Phase III Trial of Accelerated Whole Breast Irradiation With Hypofractionation Plus Concurrent Boost Versus Standard Whole Breast Irradiation Plus Sequential Boost for Early-Stage Breast Cancer
RATIONALE: It is not yet know whether higher per daily radiation therapy is equally as effective as standard per daily radiation therapy in treating breast cancer.
PURPOSE: This randomized phase III trial studies how well an accelerated course of higher per daily radiation therapy with concomitant boost works compared to standard per daily radiation therapy with a sequential boost in treating patients with early-stage breast cancer that was removed by surgery.
Read the detailed description
OBJECTIVES:
Primary
- To determine whether an accelerated course of hypofractionated whole-breast irradiation (WBI) including a concomitant boost to the tumor bed in 15 fractions following lumpectomy will prove to be non-inferior in local control to a regimen of standard WBI with a sequential boost following lumpectomy for early-stage breast cancer patients.
Secondary
- To determine whether breast-related symptoms and cosmesis from accelerated WBI that is hypofractionated (in only 3 weeks) with a concomitant boost is non-inferior to standard WBI with sequential boost.
- To determine whether the risk of late cardiac toxicity in patients with left-sided breast cancer treated with hypofractionation will be non-inferior to conventional fractionated radiation therapy (RT) based upon analysis of radiation dosimetry from CT-based treatment planning and normal tissue complication probability (NTCP) calculations.
- To determine whether CT-based conformal methods intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) for WBI are feasible in a multi-institutional setting following lumpectomy in early-stage breast cancer patients and whether dose-volume analyses can be established to assess treatment adequacy and likelihood of toxicity.
- To determine that cosmetic results and breast-related symptoms 3 years after hypofractionated breast radiation with concomitant boost will not be inferior to that obtained 3 years after WBI with sequential boost.
- To determine whether future correlative studies can identify individual gene expressions and biological host factors associated with toxicity and/or local recurrence from standard and hypofractionated WBI.
- If shown to be non-inferior, to then determine if accelerated course of hypofractionated WBI including a concomitant boost to the tumor bed in 15 fractions following lumpectomy will prove to be superior in local control to a regimen of standard WBI with a sequential boost following lumpectomy for early-stage breast cancer patients.
- To determine whether treatment costs for hypofractionated WBI with concomitant boost are not higher than WBI with sequential boost.
OUTLINE: This is a multicenter study. Patients are stratified according to age (< 50 vs. ≥ 50 years), prior chemotherapy (yes vs. no), estrogen-receptor status (+ vs. -), and histology grade (1-2 vs. 3). Patients are randomized to 1 of 2 treatment arms. Treatment begins within 9 weeks of last surgery or chemotherapy delivery.
After completion of study therapy, patients are followed at 1 month, at 6 months, and then yearly.
- Conditions
- Breast Cancer
- Being tested
- Standard fractionation whole breast irradiation, Hypofractionated whole breast irradiation, Concurrent boost, Sequential boost
- Keywords
- stage IA breast cancer, stage IB breast cancer, stage II breast cancer, estrogen receptor-negative breast cancer, estrogen receptor-positive breast cancer, progesterone receptor-negative breast cancer, progesterone receptor-positive breast cancer, ductal breast carcinoma in situ
- Medical subject headings
- Breast Neoplasms, Carcinoma, Intraductal, Noninfiltrating
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Standard fractionation whole breast irradiationRadiation
Also called three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT)
Target-based radiation using three-dimensional conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) to deliver 25 fractions of 2.0 Gy for a total dose of 50.0 Gy or 16 fractions of 2.67 Gy for a total dose of 42.7 Gy. Must begin within 9 weeks of last surgery or chemotherapy delivery.
Hypofractionated whole breast irradiationRadiation
Also called three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT)
Target-based radiation using three-dimensional conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) to deliver 15 fractions of 2.67 Gy for a total dose of 40.0 Gy. Must begin within 9 weeks of last surgery or chemotherapy delivery.
Concurrent boostRadiation
15 fractions of 3.2 Gy for a total dose of 48 Gy to the lumpectomy cavity. Given concurrently with treatment to the entire breast. May be given by either electron beam or photon beams using either 3D-CRT or IMRT.
Sequential boostRadiation
6 fractions of 2.0 Gy per fraction for a total dose of 12 Gy or 7 fractions of 2.0 Gy for a total dose of 14 Gy to the lumpectomy cavity. May be given by either electron beam or photon beams using either 3D-CRT or IMRT. Begins without a treatment break after completion of the treatment to the entire breast.
| Study group | Role | What they receive |
|---|---|---|
| Whole breast irradiation + sequential boost | Active comparator | Standard fractionation whole breast irradiation (WBI) with sequential boost. Receives: Radiation: Standard fractionation whole breast irradiation; Radiation: Sequential boost |
| Hypofractionated whole breast irradiation + concurrent boost | Experimental | Hypofractionated whole breast (H-WBI) irradiation with a concurrent boost Receives: Radiation: Hypofractionated whole breast irradiation; Radiation: Concurrent boost |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants With In-breast Recurrence (Local Failure)
In-breast recurrence (IBR) is defined as any of the following: invasive local recurrence-ipsilateral breast (within treatment field); invasive local recurrence-ipsilateral breast (outside treatment field); non-invasive local recurrence-ipsilateral breast (within treatment field); or non-invasive local recurrence-ipsilateral breast (outside treatment field). Time to IBR is defined as time from randomization to the date of first IBR, last known follow-up (censored), or death without IBR (competing risk). IBR rates are estimated using the cumulative incidence method, while treatment effect comparisons are based on cause-specific hazards. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. 5-year rates are provided.
Measured: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years. Five-year rates are reported here.
Secondary outcomes (9)
Percentage of Participants Alive
Failure is defined as death due to any cause. Failure time (overall survival time) is defined as the time from randomization to the date of death or last known follow-up (censored). Overall survival rates are estimated by the Kaplan-Meier method and distributions between the two arms are compared using the log-rank test. Five-year rates are provided here.
Measured: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years. Five-year rates are provided here.
Percentage of Participants Alive Without Disease
Disease-free survival (DFS) time is defined as time from randomization to local-regional disease recurrence, distant metastases, second/new primary, death due to any cause or last known follow-up (censored). DFS rates are estimated by the Kaplan-Meier method and distributions between the two arms are compared using the log-rank test. Five-year rates are provided here.
Measured: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years. Five-year rates are provided here.
Percentage of Participants Alive Without Distant Disease
Distant disease-free survival (DDFS) time is defined as time from randomization to distant metastases, second/new primary, death due to any cause or last known follow-up (censored). DDFS rates are estimated by the Kaplan-Meier method and distributions between the two arms are compared using the log-rank test. Five-year rates are provided here.
Measured: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years. Five-year rates are provided here.
Number of Participants by Highest Grade Adverse Event Reported as Definitely, Probably, or Possibly Related to Protocol Treatment
Common Terminology Criteria for Adverse Events (version 4.0) grades adverse event severity from 1=mild to 5=death. Summary data is provided in this outcome measure; see Adverse Events Module for specific adverse event data
Measured: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years.
Change in Breast Cancer Treatment Outcome Scale (BCTOS) Cosmesis Subscale Score From Baseline to 3 Years
The BCTOS cosmesis subscale score measures perceived aesthetic (e.g., breast shape) status . Patients rated each item using a four-point scale evaluating the differences between the treated and the untreated breast (1=no difference, 2=slight difference, 3=moderate difference, 4=large difference) with higher scores indicating a worse outcome. The score for each subscale is the mean of the ratings over all items belonging to that specific subscale. Change was calculated as the value at 3 years minus the value at baseline. A positive change reflects a decline at 3 years and a negative change reflects an improvement at 3 years.
Measured: Baseline and 3 years
Percentage of Participants With a Physician-reported Cosmetic Score of Excellent or Good at 3 Years
Physicians rated cosmesis using a four point scale:
- Excellent: When compared to the untreated breast or the original appearance of the breast, there is minimal/no difference in the size or shape of the treated breast.
- Good: There is a slight difference in the size or shape of the treated breast as compared to the opposite breast or the original appearance of the treated breast.
- Fair: Obvious differences in the size and shape of the treated breast. This change involves quarter or less of the breast.
- Poor: Marked change in the appearance of the treated breast involving more than a quarter of the breast tissue.
Measured: 3 years
Correlation Between Dose-volume Data and Both Adverse Events and Efficacy
Measured: From randomization to end of follow-up.
Translational Research of Single Nucleotide Polymorphisms (SNPs) in Transforming Growth Factor Beta 1 (TGFB1) and Ataxia-Telangiesctasia Mutated (ATM) Genes
Measured: From randomization to last follow-up.
Treatment Cost
Measured: From randomization to end of treatment.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 May 2011 (estimated)
- Study start24 May 2011
- Primary completion25 Jan 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 2,354 participants (actual)
Sponsor and investigators
- Lead sponsor
- Radiation Therapy Oncology Group
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI), NRG Oncology
- Responsible party
- Sponsor
- Investigators
- Frank A. Vicini, MD, FACR, Principal investigator, St. Joseph Mercy OaklandGary M. Freedman, MD, Study chair, University of PennsylvaniaJulia R. White, MD, Study chair, Ohio State UniversityDouglas W. Arthur, MD, Study chair, Virginia Commonwealth University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01349322
- Sponsor's protocol ID
- RTOG-1005
- Other IDs
- NCI-2011-02669, CDR0000700069
- Status last verified
- Sep 2025
- First submitted
- 5 May 2011
- Last updated
- 5 Mar 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Vicini FA, Winter K, Freedman GM, Arthur DW, Rosenstein BS, Bentzen SM, Li XA, Halyard MY, Woodward WA, Bleicher RJ, Taghian A, Lyons J, Tomberlin JK, Seaward SA, Cheston SB, Hoover AC, Anderson BM, Perera FE, Poppe MM, Petersen IA, Jhawar S, Hijal T, Moughan J, Movsas B, White JR. Concurrent Versus Sequential Radiation Dose Escalation to the Surgical Cavity for Conservative Treatment of High-Risk Early Breast Cancer: NRG/RTOG 1005 Phase III Trial. J Clin Oncol. 2026 Jul;44(19):1798-1811. doi: 10.1200/JCO-25-02465. Epub 2026 May 11.
PubMed 42114027
Study at a glance
From the registry record, last updated by the sponsor on 5 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III Trial of Accelerated Whole Breast Irradiation With Hypofractionation Plus Concurrent Boost Versus Standard Whole Breast Irradiation Plus Sequential Boost for Early-Stage Breast Cancer
- ClinicalTrials.gov ID
- NCT01349322
- Acronym / sponsor ID
- RTOG-1005
- Conditions
- Breast Cancer
- Keywords
- stage IA breast cancer, stage IB breast cancer, stage II breast cancer, estrogen receptor-negative breast cancer, estrogen receptor-positive breast cancer, progesterone receptor-negative breast cancer, progesterone receptor-positive breast cancer, ductal breast carcinoma in situ
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 2,354 participants (actual)
- Lead sponsor
- Radiation Therapy Oncology GroupResearch network
- Collaborators
- National Cancer Institute (NCI), NRG Oncology
- Study start
- 24 May 2011 (actual)
- Primary completion
- 25 Jan 2022 (actual)
- First posted
- 6 May 2011 (estimated)
- Results
- Posted 6 Apr 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: It is not yet know whether higher per daily radiation therapy is equally as effective as standard per daily radiation therapy in treating breast cancer.
PURPOSE: This randomized phase III trial studies how well an accelerated course of higher per daily radiation therapy with concomitant boost works compared to standard per daily radiation therapy with a sequential boost in treating patients with early-stage breast cancer that was removed by surgery.
Detailed description
OBJECTIVES:
Primary
- To determine whether an accelerated course of hypofractionated whole-breast irradiation (WBI) including a concomitant boost to the tumor bed in 15 fractions following lumpectomy will prove to be non-inferior in local control to a regimen of standard WBI with a sequential boost following lumpectomy for early-stage breast cancer patients.
Secondary
- To determine whether breast-related symptoms and cosmesis from accelerated WBI that is hypofractionated (in only 3 weeks) with a concomitant boost is non-inferior to standard WBI with sequential boost.
- To determine whether the risk of late cardiac toxicity in patients with left-sided breast cancer treated with hypofractionation will be non-inferior to conventional fractionated radiation therapy (RT) based upon analysis of radiation dosimetry from CT-based treatment planning and normal tissue complication probability (NTCP) calculations.
- To determine whether CT-based conformal methods intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) for WBI are feasible in a multi-institutional setting following lumpectomy in early-stage breast cancer patients and whether dose-volume analyses can be established to assess treatment adequacy and likelihood of toxicity.
- To determine that cosmetic results and breast-related symptoms 3 years after hypofractionated breast radiation with concomitant boost will not be inferior to that obtained 3 years after WBI with sequential boost.
- To determine whether future correlative studies can identify individual gene expressions and biological host factors associated with toxicity and/or local recurrence from standard and hypofractionated WBI.
- If shown to be non-inferior, to then determine if accelerated course of hypofractionated WBI including a concomitant boost to the tumor bed in 15 fractions following lumpectomy will prove to be superior in local control to a regimen of standard WBI with a sequential boost following lumpectomy for early-stage breast cancer patients.
- To determine whether treatment costs for hypofractionated WBI with concomitant boost are not higher than WBI with sequential boost.
OUTLINE: This is a multicenter study. Patients are stratified according to age (< 50 vs. ≥ 50 years), prior chemotherapy (yes vs. no), estrogen-receptor status (+ vs. -), and histology grade (1-2 vs. 3). Patients are randomized to 1 of 2 treatment arms. Treatment begins within 9 weeks of last surgery or chemotherapy delivery.
After completion of study therapy, patients are followed at 1 month, at 6 months, and then yearly.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Whole breast irradiation + sequential boost | Active comparator | Radiation: Standard fractionation whole breast irradiation, Radiation: Sequential boostStandard fractionation whole breast irradiation (WBI) with sequential boost. |
| Hypofractionated whole breast irradiation + concurrent boost | Experimental | Radiation: Hypofractionated whole breast irradiation, Radiation: Concurrent boostHypofractionated whole breast (H-WBI) irradiation with a concurrent boost |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (52 listed)
- Pathologically proven diagnosis of breast cancer resected by lumpectomy and whole breast irradiation with boost without regional nodal irradiation planned
- The patient must be female
- The patient must meet at least one of the three following criteria:
- Study entry must be within 50 days from whichever comes later: last surgery (breast or axilla) or last chemotherapy. The day of surgery is Day "0".
- If multifocal breast cancer, then it must have been resected through a single lumpectomy incision with negative margins
Key exclusion criteria (26 listed)
- American Joint Committee on Cancer (AJCC) pathologic T4, N2 or N3, M1 pathologic stages III or IV breast cancer
- Treatment plan that includes regional node irradiation
- Prior invasive non-breast malignancy (except non-melanomatous skin cancer, carcinoma in situ of the cervix) unless disease free for a minimum of 5 years prior to study entry
- Prior invasive or in-situ carcinoma of the breast [-prior lobular carcinoma in situ (LCIS) is eligible]
- Two or more breast cancers not resectable through a single lumpectomy incision
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Standard fractionation whole breast irradiationAlso: three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT)Target-based radiation using three-dimensional conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) to deliver 25 fractions of 2.0 Gy for a total dose of 50.0 Gy or 16 fractions of 2.67 Gy for a total dose of 42.7 Gy. Must begin within 9 weeks of last surgery or chemotherapy delivery. | Radiation | Whole breast irradiation + sequential boost |
| Hypofractionated whole breast irradiationAlso: three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT)Target-based radiation using three-dimensional conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) to deliver 15 fractions of 2.67 Gy for a total dose of 40.0 Gy. Must begin within 9 weeks of last surgery or chemotherapy delivery. | Radiation | Hypofractionated whole breast irradiation + concurrent boost |
| Concurrent boost15 fractions of 3.2 Gy for a total dose of 48 Gy to the lumpectomy cavity. Given concurrently with treatment to the entire breast. May be given by either electron beam or photon beams using either 3D-CRT or IMRT. | Radiation | Hypofractionated whole breast irradiation + concurrent boost |
| Sequential boost6 fractions of 2.0 Gy per fraction for a total dose of 12 Gy or 7 fractions of 2.0 Gy for a total dose of 14 Gy to the lumpectomy cavity. May be given by either electron beam or photon beams using either 3D-CRT or IMRT. Begins without a treatment break after completion of the treatment to the entire breast. | Radiation | Whole breast irradiation + sequential boost |
Primary outcome
Percentage of Participants With In-breast Recurrence (Local Failure)
Time frame: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years. Five-year rates are reported here.
In-breast recurrence (IBR) is defined as any of the following: invasive local recurrence-ipsilateral breast (within treatment field); invasive local recurrence-ipsilateral breast (outside treatment field); non-invasive local recurrence-ipsilateral breast (within treatment field); or non-invasive local recurrence-ipsilateral breast (outside treatment field). Time to IBR is defined as time from randomization to the date of first IBR, last known follow-up (censored), or death without IBR (competing risk). IBR rates are estimated using the cumulative incidence method, while treatment effect comparisons are based on cause-specific hazards. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. 5-year rates are provided.
9 secondary outcomes
Percentage of Participants Alive
Time frame: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years. Five-year rates are provided here.
Percentage of Participants Alive Without Disease
Time frame: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years. Five-year rates are provided here.
Percentage of Participants Alive Without Distant Disease
Time frame: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years. Five-year rates are provided here.
Number of Participants by Highest Grade Adverse Event Reported as Definitely, Probably, or Possibly Related to Protocol Treatment
Time frame: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years.
Change in Breast Cancer Treatment Outcome Scale (BCTOS) Cosmesis Subscale Score From Baseline to 3 Years
Time frame: Baseline and 3 years
Percentage of Participants With a Physician-reported Cosmetic Score of Excellent or Good at 3 Years
Time frame: 3 years
Correlation Between Dose-volume Data and Both Adverse Events and Efficacy
Time frame: From randomization to end of follow-up.
Translational Research of Single Nucleotide Polymorphisms (SNPs) in Transforming Growth Factor Beta 1 (TGFB1) and Ataxia-Telangiesctasia Mutated (ATM) Genes
Time frame: From randomization to last follow-up.
Treatment Cost
Time frame: From randomization to end of treatment.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Mar 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 42114027Vicini FA, Winter K, Freedman GM, Arthur DW, Rosenstein BS, Bentzen SM, Li XA, Halyard MY, Woodward WA, Bleicher RJ, Taghian A, Lyons J, Tomberlin JK, Seaward SA, Cheston SB, Hoover AC, Anderson BM, Perera FE, Poppe MM, Petersen IA, Jhawar S, Hijal T, Moughan J, Movsas B, White JR. Concurrent Versus Sequential Radiation Dose Escalation to the Surgical Cavity for Conservative Treatment of High-Risk Early Breast Cancer: NRG/RTOG 1005 Phase III Trial. J Clin Oncol. 2026 Jul;44(19):1798-1811. doi: 10.1200/JCO-25-02465. Epub 2026 May 11.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Frank A. Vicini, MD, FACR principal investigator
St. Joseph Mercy Oakland
Gary M. Freedman, MD study chair
University of Pennsylvania
Julia R. White, MD study chair
Ohio State University
415 sites in 8 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Standard fractionation whole breast irradiation, Hypofractionated whole breast irradiation and Concurrent boost in people with Breast Cancer, run by Radiation Therapy Oncology Group at 415 sites in 8 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 52 inclusion and 26 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 5 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 415 sites in United States, Canada, Israel, Singapore, South Korea and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 6 Apr 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percentage of Participants With In-breast Recurrence (Local Failure) (time frame: From randomization to last follow-up. Evaluated weekly during radiation therapy (RT), last day of RT, 1, 6, and 12 months after RT completion, then annually. Maximum follow-up at time of analysis was 10.1 years. Five-year rates are reported here.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01349322, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Mar 2026.