术中放疗和全乳照射在早期乳腺癌中肿瘤疗效的比较:一项meta分析

Comparison of oncological efficacy between intraoperative radiotherapy and whole-breast irradiation in early breast cancer patients:a meta analysis

目的术中放疗(IORT)和全乳照射(WBI)都是早期乳腺癌患者接受保乳手术时最有效的放疗干预选择,然而,哪项技术能给患者带来更好的肿瘤疗效目前仍存争议。本文meta分析旨在探讨IORT组和WBI组的局部无复发生存期(LRFS)、无远处转移生存期(DMFS)和总生存期(OS)的组间差异。方法截至2021年8月1日,我们分别对PubMed、Web of Science、万方、知网、维普五个数据库进行计算机化检索,以纳入符合要求的中、英文发表的临床研究。文献筛选、数据提取和质量评估一式两份。结果一共13篇(13380个患者)纳入了本文meta分析。汇总的结果表明,IORT组的LRFS明显低于WBI组的LRFS(OR=2.36;95%CI,1.66~3.35),而组间的DMFS(OR=0.99;95%CI,0.76~1.29)和OS(OR=0.95;95%CI,0.79~1.14)均无显著统计学差异。结论对于早期乳腺癌患者而言,IORT组的LRFS劣于WBI组的LRFS,而组间的DMFS和OS并无明显差异。

Objective Both intraoperative radiotherapy(IORT)and whole-breast irradiation(WBI)are effective radiotherapeutic interventions for early breast cancer patients undergoing breast-conserving surgery;however,which one can achieve better prognosis is still controversial.Our study aims to investigate the differences of local relapse-free survival(LRFS),distant metastasis-free survival(DMFS),and overall survival(OS)between groups.Methods We conducted a computerized retrieval to identify English and Chinese published related clinical articles in PubMed,Web of Science,Wangfang,CNKI and VIP databases up to August 1st,2021.Literature screening,data extraction,and quality assessment were performed in duplicate.Results A total of 13 studies with 13380 unique patients were included in this meta analysis.The pooled results showed that the LRFS in the IORT group was significantly lower than that in the WBI group(OR=2.36;95%CI,1.66-3.35),whereas the DMFS(OR=0.99;95%CI,0.76-1.29)and OS(OR=0.95;95%CI,0.79-1.14)were not statistically different between the groups.Conclusion For patients with early breast cancer,LRFS in the IORT group is inferior to that in the WBI group,albeit with the similar DMFS and OS in the groups.