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Can we safely reduce the number of days of radiotherapy needed to treat people with breast cancer who need boost treatment?

This study aims to find a shorter, safer way to give radiotherapy to about 10,000 breast cancer patients in the UK each year. These patients need an extra dose of radiation, called a 'boost', which currently means up to 23 days of treatment overall. The study wants to see if this boost can be given within a quicker 5-day radiotherapy course, similar to what most other breast cancer patients receive. Researchers will compare two different boost doses given over 5 days against the current standard of a 15-day boost. The goal is to see if the shorter treatment is just as good at stopping the cancer from coming back, with similar or fewer side effects, and a faster recovery.

At a glance

Status
Recruiting
Sponsor
Institute of Cancer Research
Enrolment target
4,830
Start
01 Apr 2025
Estimated completion
30 Sep 2028

What is this study about?

Each year, many people in the UK are diagnosed with breast cancer and need radiotherapy as part of their treatment. Radiotherapy uses special rays to kill cancer cells and stop them from growing. Most people in the UK can now have their radiotherapy delivered over just 5 days, which is much quicker than it used to be. However, some people need an extra, higher dose of radiation called a 'boost' to the area where the tumour was removed. This boost is often given over an additional 15 days, meaning their overall treatment takes much longer, sometimes up to 23 days.

This study, called FAST-Forward Boost, is trying to find out if we can safely shorten the boost treatment from 15 days to just 5 days. This would mean that more people could complete their entire radiotherapy course in a similar 5-day timeframe, making treatment much more convenient and potentially reducing stress and needing fewer hospital visits. The researchers want to see if this shorter boost is just as effective at preventing the cancer from coming back and if it causes similar or fewer side effects.

To do this, the study will compare three different ways of giving the boost. One group will get the standard 15-day boost. The other two groups will get their boost over 5 days, but with slightly different radiation doses to see which is best. The information gathered from this study will help doctors decide the best and most efficient way to give radiotherapy to breast cancer patients who need a boost.

Key takeaways

  • This study aims to make breast cancer radiotherapy shorter and more convenient.
  • It compares a new 5-day radiotherapy 'boost' with the current 15-day boost.
  • Participation involves being randomly assigned to a treatment group.
  • Patients will share information about their health for five years.
  • The goal is to find a treatment that is equally effective with similar or fewer side effects.
  • You can stop participating at any time.

Who may be eligible?

This study is looking for people aged 18 or over who have been diagnosed with breast cancer and have had surgery to remove the tumour, but not a full mastectomy. Your medical team will have decided that you need an extra dose of radiotherapy, called a boost, to the area where the tumour was removed, as well as regular radiotherapy to your breast and possibly nearby lymph nodes. Your surgeon must also confirm that all the cancer cells were removed during surgery. You might also be eligible if you have a condition called DCIS (Ductal Carcinoma In Situ) and need a boost.

There are a few reasons why you might not be able to join the study. For instance, if you've had a full mastectomy on the affected side, or if you've had radiotherapy to the same area of your chest before. You also can't take part if your cancer has spread to other parts of your body. Similarly, if you are pregnant or breastfeeding, or if you are already involved in another specific clinical trial called PARABLE, you wouldn't be able to join this study.

Your breast cancer must be in its early stages (T1-T3, N0-3, M0 are medical terms for this) and confirmed by lab tests. If you have cancer in both breasts at the same time, at least one of them needs to meet these specific requirements for you to be considered for the trial.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

  1. Are you 18 years old or older?
  2. Do you have breast cancer and need an extra 'boost' of radiotherapy?
  3. Did you have surgery to remove the lump (but not a full mastectomy)?
  4. Has your doctor confirmed all the cancer was removed during surgery?
  5. Have you *not* had radiotherapy to the same part of your chest before?
  6. Is your cancer *not* considered to have spread to other parts of your body?
Answer every question to see your result.

What does participation involve?

If you decide to take part in this study, you'll be randomly assigned by a computer to one of three treatment groups. This is a bit like drawing names from a hat, and ensures fairness. One group will receive the standard 15-day boost radiotherapy. The other two groups will receive their boost radiotherapy over 5 days, but with slightly different radiation doses.

During and after your treatment, you will be asked to provide information about how you are feeling. This includes details about any side effects you might experience, any changes to the breast that was treated, how tired you might feel, and your general quality of life. You will be asked to share this information regularly for five years after your treatment. The study team and your doctor will guide you on when and how to provide this information.

Potential risks and benefits

Participating in this study could offer some potential benefits. The main goal is to show that a shorter 5-day boost treatment is just as good as the standard 15-day treatment at preventing cancer from returning, while potentially causing similar or fewer side effects and leading to a faster recovery. This could mean fewer hospital visits and less disruption to your life. As with any medical treatment, there are also potential risks. You might experience common side effects from radiotherapy, and there's a possibility that the shorter treatment might not be as effective as the standard longer one, although the study is designed to carefully monitor this. Remember, you can choose to leave the study at any time, for any reason, without it affecting your usual medical care.

Locations (41)

  • Royal Marsden Hospital
    Approximate
    Sutton, United Kingdom
  • The Royal Marsden Hospital (london)
    Approximate
    London, United Kingdom
  • The Christie
    Approximate
    Manchester, United Kingdom
  • Addenbrookes
    Approximate
    Cambridge, United Kingdom
  • Beatson West of Scotland Cancer Centre
    City only
    Glasgow, United Kingdom
  • Belfast City Hospital
    Approximate
    Belfast, United Kingdom
  • Bristol Haematology & Oncology Centre
    Approximate
    Bristol, United Kingdom
  • Charing Cross Hospital
    Approximate
    London, United Kingdom
  • Cheltenham General Hospital
    Approximate
    Cheltenham, United Kingdom
  • Churchill Hospital
    Approximate
    Oxford, United Kingdom
  • Clatterbridge Cancer Centre
    Unverified
    Wirral, United Kingdom
  • Derriford Hospital
    Unverified
    Plymouth, United Kingdom

Common questions

What is a 'boost' in radiotherapy?

A boost is an extra, higher dose of radiation given to the specific area where the breast tumour was removed, after the initial radiotherapy to the whole breast. It aims to reduce the chance of the cancer coming back in that spot.

What does being 'randomised' mean?

Being randomised means a computer will fairly and randomly place you into one of the treatment groups, like flipping a coin. This helps make sure the study results are reliable.

How long will I be followed up in this study?

You will be asked to provide information about your health and how you are doing for five years after your radiotherapy treatment.

Can I choose which group I go into?

No, you cannot choose which group you go into. The computer makes this decision randomly to ensure the study is fair and accurate.

Who is paying for this research?

The study is funded by the National Institute for Health and Care Research (NIHR), which is a major UK-based organisation supporting health research.

How to find out more

Mark Sydenham

Always speak to your GP or specialist before deciding to take part in a study.

Discussion

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