Department of Medical Oncology, University General Hospital of Heraklion, Greece.
Breast J. 2010 May-Jun;16(3):245-51. doi: 10.1111/j.1524-4741.2010.00905.x. Epub 2010 Feb 23.
The purpose of the study was to compare treatment outcomes in patients with breast cancer treated with partial breast irradiation (PBI) and of those treated with whole breast-radiation therapy (WBRT). We conducted a systematic review and meta-analysis of published randomized clinical trials comparing PBI versus WBRT. Primary outcome was overall survival and secondary outcomes were locally, axillary, supraclavicular, and distant recurrences. A search of the literature identified three trials with pooled total of 1,140 patients. We found no statistically significant difference between partial and whole breast radiation arms associated with death (OR 0.912, 95% CI 0.674-1.234, p = 0.550), distant metastasis (OR 0.740, 95% CI, 0.506-1.082, p = 0.120), or supraclavicular recurrences (pooled OR 1.415, 95% CI 0.278-7.202, p = 0.560). However, PBI was statistically significantly associated with an increased risk of both local (pooled OR 2.150, 95% CI, 1.396-3.312; p = 0.001) and axillary recurrences (pooled OR 3.430, 95% CI, 2.058-5.715; p < 0.0001) compared with whole breast-radiation. Partial breast irradiation does not seem to jeopardize survival and may be used as an alternative to whole breast-radiation. Nevertheless the issue of loco-regional recurrence needs to be further addressed.
本研究旨在比较接受部分乳房照射(PBI)和全乳房放射治疗(WBRT)的乳腺癌患者的治疗结果。我们对比较 PBI 与 WBRT 的已发表随机临床试验进行了系统评价和荟萃分析。主要结局是总生存率,次要结局是局部、腋窝、锁骨上和远处复发。文献检索确定了三项共纳入 1140 例患者的试验。我们发现,部分乳房照射组和全乳房照射组在死亡(OR 0.912,95%CI 0.674-1.234,p=0.550)、远处转移(OR 0.740,95%CI,0.506-1.082,p=0.120)或锁骨上复发(合并 OR 1.415,95%CI 0.278-7.202,p=0.560)方面无统计学差异。然而,与全乳房放射治疗相比,PBI 与局部(合并 OR 2.150,95%CI,1.396-3.312;p=0.001)和腋窝复发(合并 OR 3.430,95%CI,2.058-5.715;p<0.0001)风险增加均具有统计学意义。与全乳房放射治疗相比,部分乳房照射似乎不会危及生存,并且可以作为全乳房放射治疗的替代方法。然而,局部区域复发的问题仍需要进一步解决。