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Hypofractionated vs. Conventionally Fractionated Postmastectomy Radiotherapy After Implant-Based Reconstruction

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About this study

This is a prospective, randomized controlled, non-inferiority clinical trial designed to compare the outcomes of hypofractionated radiotherapy versus conventionally fractionated radiotherapy following mastectomy and implant-based breast reconstruction. The primary objective is to evaluate whether hypofractionated radiotherapy is non-inferior to conventionally fractionated radiotherapy regarding the rate of unplanned reoperation.

Condition
Breast Cancer, Implant Breast Reconstruction
Tested
ConvRT, HypoRT
Sponsor
Fudan University

Who can join

Age
18 years and older
Sex
Female only
Healthy volunteers
Not accepted

Inclusion 14

  • Minimum age: 18 years
  • Eligible sex: Female
  • Study condition: Breast Cancer, Implant Breast Reconstruction
  • Female patients aged ≥ 18 years.
  • Pathologically confirmed unilateral primary invasive breast cancer.
  • Underwent skin-sparing (SSM) or nipple-sparing mastectomy (NSM) with axillary staging (sentinel lymph node biopsy or axillary lymph node dissection).
  • Underwent 1-stage (direct-to-implant) or 2-stage (tissue expander) reconstruction, or implant combined with autologous tissue, with prepectoral or subpectoral placement.
  • Received standard neoadjuvant or adjuvant systemic therapy (chemotherapy, endocrine, anti-HER2, or targeted therapy) according to guidelines or clinical trial protocols.
  • Definite indication for post-mastectomy chest wall ± regional nodal irradiation according to guidelines (typically c/pT1-3 N0-3 M0).
  • Interval of at least 6 weeks between reconstruction surgery and the initiation of radiotherapy.
  • ECOG performance status 0-1.
  • Prior non-breast malignancy permitted if disease-free for \> 5 years with low recurrence risk; prior cervical or colon carcinoma in situ, melanoma in situ, basal cell carcinoma, or squamous cell skin carcinoma permitted regardless of disease-free interval.
  • Estimated life expectancy ≥ 10 years.
  • Written informed consent provided.

Exclusion 7

  • Pregnant or lactating patients.
  • Prior history of breast cancer.
  • Bilateral breast cancer.
  • Prior radiotherapy to the ipsilateral chest wall or regional lymph node areas.
  • T4 disease (including, but not limited to, inflammatory breast cancer, regardless of response to neoadjuvant systemic therapy).
  • Non-breast malignancy within the past 5 years (except cervical or colon carcinoma in situ, melanoma in situ, basal cell carcinoma, or squamous cell skin carcinoma).
  • Severe non-malignant comorbidities (e.g., cardiovascular disease, pulmonary disease, systemic lupus erythematosus, or scleroderma) precluding radiotherapy tolerance or follow-up compliance.

Where

1 site, 1 recruiting

Fudan University Shanghai Cancer Center

Shanghai, China

Recruiting

Contact

Potential match only. Final eligibility is determined by the study team.