Trial Information

Novel Surrogate Markers as Predictors of Radiation Toxicity in Breast Cancer Patients Undergoing Helical Tomotherapy Compared to Standard Radiation Therapy

Radiotherapy is standard treatment after conservative surgery for early-stage breast cancer.
Although this approach substantially improves local control and reduces deaths from breast
cancer, it also results in some severe late side-effects, including skin fibrosis, deaths
from radiation-induced cardiac disease and lung cancer. We will undertake a novel approach
to the evaluation of radiation-induced toxicity during and after whole breast irradiation
(RT) following breast-conserving surgery, with the long-term strategic goal of minimizing RT
toxicity in early breast cancer. Theoretically, it is possible to achieve this goal through
very highly conformal RT delivery and avoidance of RT in toxicity-prone individuals where
possible. We plan to evaluate the utility of genomic analysis, cellular DNA repair
competence, and functional imaging endpoints as predictive markers of toxicity in our breast
cancer population. This program is expected to (a) prospectively validate that HT for
breast RT can decrease acute toxicity whilst maintaining excellent cancer control after BCS;
(b) demonstrate that novel surrogate markers will aid in the prediction of acute and/or late
normal tissue toxicity with a view to identify toxicity-prone (or conversely, robust)
individuals from amongst the breast cancer population.