Pragmatic randomised clinical trial of proton versus photon therapy for patients with non-metastatic breast cancer: The Radiotherapy Comparative Effectiveness (RadComp) Consortium trial protocol Journal Article


Authors: Bekelman, J. E.; Lu, H.; Pugh, S.; Baker, K.; Berg, C. D.; De Gonzalez, A. B.; Braunstein, L. Z.; Bosch, W.; Chauhan, C.; Ellenberg, S.; Fang, L. C.; Freedman, G. M.; Hahn, E. A.; Haffty, B. G.; Khan, A. J.; Jimenez, R. B.; Kesslering, C.; Ky, B.; Lee, C.; Lu, H. M.; Mishra, M. V.; Mullins, C. D.; Mutter, R. W.; Nagda, S.; Pankuch, M.; Powell, S. N.; Prior, F. W.; Schupak, K.; Taghian, A. G.; Wilkinson, J. B.; MacDonald, S. M.; Cahlon, O.; RadComp (Radiotherapy Comparative Effectiveness Consortium)
Contributors: Cuaron, J.; Gelblum, D.; Gillespie, E.; Hong, L.; McCormick, B.; Mychalczak, B.; Parhar, P.; Romesser, P.; Shepherd, A. M.
Article Title: Pragmatic randomised clinical trial of proton versus photon therapy for patients with non-metastatic breast cancer: The Radiotherapy Comparative Effectiveness (RadComp) Consortium trial protocol
Abstract: Introduction A broad range of stakeholders have called for randomised evidence on the potential clinical benefits and harms of proton therapy, a type of radiation therapy, for patients with breast cancer. Radiation therapy is an important component of curative treatment, reducing cancer recurrence and extending survival. Compared with photon therapy, the international treatment standard, proton therapy reduces incidental radiation to the heart. Our overall objective is to evaluate whether the differences between proton and photon therapy cardiac radiation dose distributions lead to meaningful reductions in cardiac morbidity and mortality after treatment for breast cancer. Methods We are conducting a large scale, multicentre pragmatic randomised clinical trial for patients with breast cancer who will be followed longitudinally for cardiovascular morbidity and mortality, health-related quality of life and cancer control outcomes. A total of 1278 patients with non-metastatic breast cancer will be randomly allocated to receive either photon or proton therapy. The primary outcomes are major cardiovascular events, defined as myocardial infarction, coronary revascularisation, cardiovascular death or hospitalisation for unstable angina, heart failure, valvular disease, arrhythmia or pericardial disease. Secondary endpoints are urgent or unanticipated outpatient or emergency room visits for heart failure, arrhythmia, valvular disease or pericardial disease. The Radiotherapy Comparative Effectiveness (RadComp) Clinical Events Centre will conduct centralised, blinded adjudication of primary outcome events. Ethics and dissemination The RadComp trial has been approved by the institutional review boards of all participating sites. Recruitment began in February 2016. Current version of the protocol is A3, dated 08 November 2018. Dissemination plans include presentations at scientific conferences, scientific publications, stakeholder engagement efforts and presentation to the public via lay media outlets. Trial registration number NCT02603341. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords: radiation oncology; clinical trials; breast tumours; protocols & guidelines
Journal Title: BMJ Open
Volume: 9
Issue: 10
ISSN: 2044-6055
Publisher: BMJ Publishing Group Ltd.  
Date Published: 2019-10-01
Start Page: e025556
Language: English
DOI: 10.1136/bmjopen-2018-025556
PUBMED: 31619413
PROVIDER: scopus
PMCID: PMC6797426
DOI/URL:
Notes: Article -- Export Date: 1 November 2019 -- Source: Scopus
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  1. Simon Nicholas Powell
    331 Powell
  2. Preeti Kanwal Parhar
    15 Parhar
  3. Daphna Y Gelblum
    227 Gelblum
  4. Linda Xueqi Hong
    88 Hong
  5. Oren Cahlon
    158 Cahlon
  6. Karen D Schupak
    72 Schupak
  7. Beryl McCormick
    371 McCormick
  8. Paul Bernard Romesser
    189 Romesser
  9. John Jacob Cuaron
    142 Cuaron
  10. Annemarie Fernandes Shepherd
    103 Shepherd
  11. Atif Jalees Khan
    152 Khan
  12. Erin Faye Gillespie
    149 Gillespie