乳腺癌乳房切除术后大分割与常规分割放疗的<i>Meta分析</i>

doi:10.3760/cma.j.issn.1004-4221.2019.09.010

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摘要目的比较乳腺癌乳房切除术后大分割放疗与常规放疗之间的疗效差异。方法计算机检索PubMed、EMbase、Cochrane图书馆、万方、维普、CNKI及中国生物医学等数据库,搜集有关乳腺癌乳房切除术后大分割放疗与常规放疗比较的临床对照研究资料,汇总数据采用RevMan5.3及Stata14.0软件进行分析。两组间差异采用优势比(OR)及95%可信区间(95%CI)描述。结果根据纳入和排除标准,最终纳入19个包括2652例患者的临床对照资料。Meta分析结果显示,大分割组与常规分割组两组间无瘤生存率(OR=1.10,95%CI=0.78~1.56,P=0.59),总生存率(OR=1.18,95%CI=0.92~1.53,P=0.19)、局部区域复发率(OR=1.01,95%CI=0.68~1.51,P=0.96)、远处转移率(OR=1.14,95%CI=0.82~1.59,P=0.43)、皮肤不良反应(OR=1.01,95%CI=0.80~1.26,P=0.96)、心脏不良反应(OR=1.17,95%CI=0.71~1.93,P=0.53)及肺不良反应(OR=0.78,95%CI=0.44~1.37,P=0.38)均相近。结论乳腺癌乳房切除术后大分割放疗与常规放疗疗效相近,均是安全有效的放疗分割模式,但还需大型随机临床试验进一步证实,并长期随访患者的晚期并发症。

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	刘磊
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	朱雅群
	田野

关键词 ：乳腺肿瘤/外科学, 乳腺肿瘤/放射疗法, 荟萃分析

Abstract：Objective To compare the efficacy between hypofractionated radiotherapy versus conventionally fractionated radiotherapy in post-mastectomy breast cancer by a meta-analysis. Methods The controlled clinical trials of comparing hypofractionated radiotherapy versus conventionally fractionated radiotherapy in post-mastectomy breast cancer were searched from PubMed,EMbase,Cochrane Library,Wanfang database,VIP,CNKI,and CBM databases. The obtained data were analyzed using RevMan 5.3 and Stata 14.0 software. The differences between two groups were estimated by calculating the odds ratio (OR) with 95% confidence interval (CI). Results A total of 19 controlled clinical trials involving 2652 post-mastectomy breast cancer patients were selected in this meta-analysis according to the inclusion and exclusion criteria. The meta-analysis results demonstrated that no statistical significance was observed in the tumor-free survival (OR=1.10,95%CI:0.78-1.56,P=0.59), overall survival (OR=1.18,95%CI:0.92-1.53,P=0.19), locoregional recurrence (OR=1.01,95%CI:0.68-1.51,P=0.96), distant metastasis (OR=1.14,95%CI:0.82-1.59,P=0.43), skin toxicity (OR=1.01,95%CI=0.80-2.16,P=0.96), cardiac toxicity (OR=1.17,95%CI:0.71-1.93,P=0.53) and pulmonary toxicity (OR=0.78,95%CI:0.44-1.37,P=0.38) between two groups. Conclusions Hypofractionated radiotherapy and conventionally fractionated radiotherapy post-mastectomy yield similar clinical efficacy, both of which are safe and efficacious radiotherapy patterns. However, the findings remain to be validated by large-scale randomized clinical trials with long-term follow-up of the advanced stage complications.

Key words： Breast neoplasm/surgery Breast neoplasm/radiotherapy Meta-analysis

收稿日期: 2019-01-23

基金资助:江苏省医学创新团队A类(CXDT-37);姑苏卫生领军人才(62)

通讯作者: 田野,Email:dryetian@126.com

引用本文:

刘磊,任毕欣,杨咏强等. 乳腺癌乳房切除术后大分割与常规分割放疗的Meta分析[J]. 中华放射肿瘤学杂志, 2019, 28(9): 682-686.

Liu Lei,Ren Bixin,Yang Yongqiang et al. A meta-analysis of comparing hypofractionated radiotherapy versus conventionally fractionated radiotherapy in post-mastectomy breast cancer[J]. Chinese Journal of Radiation Oncology, 2019, 28(9): 682-686.

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