Post-Mastectomy Radiotherapy for Breast Cancer Patients with T1-T2 and 1-3 Positive Lymph Nodes: a Meta-Analysis

被引:12
作者
Li, Yaming [1 ]
Moran, Meena S. [2 ]
Huo, Qiang [1 ]
Yang, Qifeng [1 ,3 ,4 ]
Haffty, Bruce G. [3 ,4 ]
机构
[1] Shandong Univ, Sch Med, Qilu Hosp, Dept Breast Surg, Jinan, Shandong, Peoples R China
[2] Yale Univ, Sch Med, Dept Therapeut Radiol, New Haven, CT 06510 USA
[3] Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Dept Radiat Oncol, New Brunswick, NJ 08901 USA
[4] Canc Inst New Jersey, New Brunswick, NJ USA
来源
PLOS ONE | 2013年 / 8卷 / 12期
基金
中国国家自然科学基金;
关键词
LOCAL RECURRENCE; HIGH-RISK; POSTOPERATIVE RADIOTHERAPY; LOCOREGIONAL FAILURE; RADIATION-THERAPY; AXILLARY NODES; IRRADIATION; SURVIVAL; MASTECTOMY; CONSENSUS;
D O I
10.1371/journal.pone.0081765
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: The role of post-mastectomy radiotherapy (PMRT) in patients with T1-2 and 1-3 positive lymph nodes remains controversial. The aim of this study is to investigate the possible benefits of PMRT for this subgroup. Methods: Three electronic databases were systematically quarried (Cochrane Library, MEDLINE, and EMBASE) for published studies evaluating the effects of PMRT on breast cancer patients with T1-T2 tumors with 1-3 positive lymph nodes. Of the 334 studies identified, information was available for 3432 patients from 10 clinical studies. Pooled relative risk estimates (RR) and overall survival (OS) were calculated using the inverse variance weighted approach, publication bias and chi-square test were also calculated. Results: From the 10 studies, the pooled RR (RRs) for locoregional recurrence (LRR) with PMRT was 0.348 (95% CI = 0.254 to 0.477), suggesting a significant benefit for PMRT to decrease the risk of LRR in patients with T1-T2 tumors and 1-3 positive nodes (p<0.05). Reporting bias (Begg's p = 0.152; Egger's p = 0.107) or significant heterogeneity (Cochran's p = 0.380; I-2 = 6.7%) were not detected. For further subset analysis, the RR for T1, N1-3+ tumors was 0.330 (95% CI = 0.171 to 0.639); for T2, N1-3+ tumors the RR was 0.226 (95% CI = 0.121 to 0.424). The pooled RR for overall survival (OS) was not significantly different between PMRT and no-PMRT group (1.051, 95% CI = 1.001 to 1.104). Conclusions: Our pooled analysis revealed that PMRT significantly reduces the risk of LRR in patients with TI-T2 tumors with 1-3 positive nodes, and the magnitude of the LRR risk reduction is slightly greater for larger tumors. Our results suggest that PMRT should be considered for patients with T1/T2 tumors with 1-3 positive nodes to decrease the relatively high risk of LRR.
引用
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页数:9
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