Ultra-Hypofractionated vs. Moderately Hypofractionated Proton Therapy for Early Breast Cancer After Lumpectomy

NCT07135661 · tracked via the Priya Life Science China tracker

Sponsor

Shanghai Proton and Heavy Ion Center

Phase

Not applicable

Started

2024-10-10

Last updated

2025-08-22

Condition(s) studied

Breast CancerProton Therapy

Investigational drug(s) / intervention(s)

moderate hypofractionated proton radiotherapyultra-hypofractionated proton radiotherapy

moderate hypofractionated proton radiotherapy: moderate hypofractionated proton radiotherapy: Whole Breast Irradiation, at 40 Gy(RBE) in 15 fractions, tumor bed SIB to 48Gy(RBE)

ultra-hypofractionated proton radiotherapy: Ultra-hypofractionated proton radiotherapy:Whole breast radiotherapy, 26 Gy(RBE) in 5 fractions，tumor bed boost with 10Gy(RBE) in 2 fractions.

Study summary

Breast-conserving surgery (BCS) followed by whole-breast irradiation (WBI) remains the standard therapeutic approach for early-stage breast cancer. Long-term follow-up data from the FAST trial (10-year analysis) demonstrated that the 28.5 Gy/5-fraction regimen exhibited comparable adverse effects to the conventional 50 Gy/25-fraction regimen, with no statistically significant differences in photographic cosmetic assessments at 2 and 5 years post-treatment. The FAST-Forward trial demonstrated comparable 5-year ipsilateral breast tumor recurrence rates (IBTR) and incidence of radiation-related toxicities between ultra-hypofractionated whole-breast irradiation (UH-WBI; 26 Gy in 5 fractions over 1 week) and moderately hypofractionated whole-breast irradiation (MH-WBI; 40 Gy in 15 fractions over 3 weeks). Additionally, no statistically significant difference in cosmetic outcomes was observed between the two regimens at the 2-year follow-up.

Proton radiotherapy enables precise dose delivery to tumor targets while minimizing radiation exposure to surrounding normal tissues, thereby reducing treatment-related toxicities. However, current clinical protocols predominantly employ conventional fractionation for proton therapy, with a paucity of robust evidence evaluating the efficacy and safety of ultra-hypofractionated proton radiotherapy in breast cancer patients. This prospective randomized controlled trial aims to establish high-level scientific evidence for the clinical application of ultra-hypofractionated proton radiotherapy following BCS, ensuring non-inferiority in oncologic control, toxicity profiles, and cosmetic preservation compared to standard regimens.

Eligibility

Sex

FEMALE

Min age

40 Years

Max age

—

Healthy volunteers

Inclusion Criteria: 1. Age ≥ 40 years 2. Pathologically (cytologically or histologically) confirmed unilateral primary invasive breast carcinoma 3. Breast conserving surgery + sentinel lymph node biopsy/axillary lymph node dissection, pathological stage pT1-2N0M0，negative margins (≥ 2 mm) 4. No distant metastasis confirmed by CT, MRI, bone scan, and PET/CT 5. No prior radiation therapy to the ipsilateral chest or breast 6. ECOG 0 \~ 2 or KPS ≥ 70 Exclusion Criteria: 1. Without pathology diagnosis 2. Positive margins or close margins (\< 2mm) 3. Lymph nodes or distant metastasis 4. Bilateral breast cancer or patients with a history of contralateral breast cancer 5. Prior radiation therapy to the ipsilateral chest or breast 6. Pregnancy (confirmed by serum or urine β-HCG test) or lactation

Primary outcome measure(s)

Cosmetic Outcomes — 2 years
Cosmetic outcomes will be assessed at 2 years after radiotherapy. Changes in breast appearance compared to baseline will be evaluated using the Breast Cancer Treatment Outcome Scale (BCTOS), independently completed by the patient, the treating physician, and a trained research assistant at each follow-up visit. Standardized photographs of the treated breast will be taken at each assessment time point and analyzed using BCCT.core software for objective cosmetic scoring.

Trial sites (1)

Facility	City	Region	Status
Shanghai Proton and Heavy Ion Center	Shanghai	China	Recruiting

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Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT07135661 on ClinicalTrials.gov ↗ ← All trials in China