Partial-breast irradiation versus whole-breast radiotherapy for early breast cancer: A systematic review and update meta-analysis
| Autor: | Gustavo Arruda Viani, Alexandre Ciufi Faustino, Ligia Issa De Fendi, Caio Viani Arruda |
|---|---|
| Přispěvatelé: | Universidade de São Paulo (USP), Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Ribeirão Preto |
| Rok vydání: | 2020 |
| Předmět: |
Oncology
medicine.medical_specialty medicine.medical_treatment Whole-breast radiotherapy Brachytherapy Subgroup analysis Breast Neoplasms Mastectomy Segmental 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences Intraoperative Period 0302 clinical medicine Breast cancer Randomized controlled trial law Internal medicine medicine Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Partial-breast irradiation BRAQUITERAPIA Randomized Controlled Trials as Topic business.industry Partial Breast Irradiation Odds ratio medicine.disease Radiation therapy Survival Rate Meta-analysis Treatment Outcome 030220 oncology & carcinogenesis Female Radiotherapy Adjuvant Neoplasm Recurrence Local business |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP Scopus Repositório Institucional da UNESP Universidade Estadual Paulista (UNESP) instacron:UNESP |
| ISSN: | 1873-1449 |
| Popis: | Made available in DSpace on 2020-12-12T01:21:27Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-07-01 Purpose: The purpose of this study was to compare the treatment outcomes of partial-breast irradiation (PBI) versus whole-breast radiotherapy (WBRT) in early breast cancer. Methods and Materials: Eligible randomized clinical trials were identified on Medline, Embase, the Cochrane Library, and the proceedings of annual meetings through December 2019. A meta-analysis for local recurrence (LR), overall mortality (OM), and non-breast cancer mortality (NBCM) was conducted. When possible, the outcomes were calculated for 5, 7, and 10 years of followup. A subgroup analysis by PBI technique (brachytherapy [BT], external beam radiotherapy [EBRT], intraoperative radiotherapy [IORT], and mixed) was performed. A p value < 0.05 was considered significant. Results: Eleven randomized clinical trials with a total of 14,436 patients (7186 PBI vs. 7250 WBRT) were included in the meta-analysis. The odds ratio (OR) for LR in 5 y was 1.46 (95% CI 1.15–2, p = 0.024) for PBI. In the subgroup analysis, no significant difference for LR was observed between PBI and WBRT using BT (p = 0.51), EBRT (p = 0.25), or mixed techniques (p = 0.89). The only subgroup with statistical difference was IORT 3.1 (95% CI 1.2–7.6, p = 0.014). No significant difference in LR was observed with 7 and 10 years among the groups. The OM had no difference at 5, 7, and 10 years of followup for any subgroup. A nonsignificant difference was observed comparing PBI with WBRT for NBCM OR = 1.24 (95% CI 0.98–1.57, p = 0.07). The rates of cardiac death, contralateral breast cancer, and development of second tumor were not significant. Conclusions: The LR with PBI is low and similar to WBRT in selected early breast cancer with a longer followup. The subgroup analysis detected a significant difference for LR associated with IORT and no significant difference for BT and EBRT. Our results confirm a nonsignificant difference for OM and NBCM between PBI and WBRT. Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP) Bioscience Institute of University of State from Sao Paulo (UNESP) Faculdade de Medicina de Ribeirão Preto Bioscience Institute of University of State from Sao Paulo (UNESP) |
| Databáze: | OpenAIRE |
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