Efficacy of prophylactic irradiation of internal mammary lymph nodes in breast cancer:a Meta-analysis
Jia Sicong1, Liu Zhikun1, Zhang Jun1, Zhao Chenguang2, Zhu Longyu1, Kong Jie1, Han Huina1, Shang Yuguang1, Shen Dongxing1, Duan Xuejuan1
1Department of Radiation Oncology, Fourth Hospital of Hebei Medical University/Hebei Cancer Hospital, Shijiazhuang 050011, China; 2Department of Internal Medicine, Fourth Hospital of Hebei Medical University/Hebei Cancer Hospital, Shijiazhuang 050011, China
Abstract:Objective To evaluate the effect of prophylactic irradiation of internal mammary lymph nodes in patients with breast cancer in this Meta-analysis. Methods CNKI, Wanfang Medical network, CBM, PubMed, EMBASE and Web of Science were searched by computer. The controlled clinical studies comparing whether or not internal mammary lymph node irradiation as an intervention were included and the quality of the included literature was evaluated according to Newcastle-Ottawa Scale (NOS). RevMan 5.3 software and Stata 14 software were used for Meta-analysis. Results A total of 11 original articles were included, and 13181 patients were included for Meta-analysis. There was no statistically significant difference in the overall survival (OS) between patients with and without internal mammary lymph node irradiation (P=0.490). The subgroup analysis using the date of treatment and the degree of risk in the enrolled population as criteria showed that 5-year OS was significantly increased after internal mammary area irradiation in high-risk stage Ⅱ-Ⅲ patients (N+, T3-T4 stage) with the date of treatment of after 2000(P=0.003, 0.006). Compared with patients without internal mammary area irradiation, internal mammary irradiation significantly increased the 5-year disease-free survival (DFS)(P<0.001). Conclusion Under the modern radiotherapy technology, internal mammary lymph node irradiation improves the DFS of patients, and may bring OS benefits to high-risk stage Ⅱ-Ⅲ breast cancer patients (N+, T3-T4 stage).
Jia Sicong,Liu Zhikun,Zhang Jun et al. Efficacy of prophylactic irradiation of internal mammary lymph nodes in breast cancer:a Meta-analysis[J]. Chinese Journal of Radiation Oncology, 2021, 30(9): 903-909.
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