Ningxia People's Hospital, Yinchuan, China.
Evidence-based Medicine Centre of Lanzhou University, Lanzhou, China.
Transl Oncol. 2013 Dec 1;6(6):619-27. doi: 10.1593/tlo.13580.
To evaluate the long-term effect of breast conservation with accelerated partial breast irradiation (APBI) for early-stage breast cancer, PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, Chinese Scientific Journals Full-text Database, and China Journal Full-text Database were searched to identify relevant original published trials. Randomized controlled trials in any language comparing APBI with whole-breast radiotherapy in patients with early-stage breast cancer were included. RevMan 5 software was used for statistical analysis. Four trials involving 919 patients were included. The rate of 5- and 7-year excellent/good cosmetic results was significant {odds ratio (OR) = 2.09 [95% confidence interval (CI) = 1.21-3.62]} between two groups. The 5- and 8-year overall survival had no significant difference [OR = 1.76 (95% CI = 0.67-4.62) and OR = 0.86 (95% CI = 0.44-1.66)]. The 10-year overall survival had significant differences [OR = 0.56 (95% CI = 0.35-0.91)]. There were no differences in the 5-year local recurrence (LR)-free survival [OR = 0.65 (95% CI = 0.18-2.34)], cancer-specific survival [OR = 1.67 (95% CI = 0.39-7.12)], disease-free survival [OR = 0.84 (95% CI = 0.38-1.84)], LR [OR = 1.36 (95% CI = 0.46-3.99)], the rate of contralateral breast cancer [OR = 2.82 (95% CI = 0.73-10.89)], and distant metastasis [OR = 0.71 (95% CI = 0.22-2.31)]. APBI significantly improved the rate of excellent/good cosmetic results anywhere in the breast, shortened the treatment time, alleviated the pain, and improved the quality of life. Future large-scale, high-quality, and double-blind trials are needed.
为了评估早期乳腺癌保乳手术后加速部分乳腺照射(APBI)的长期疗效,我们检索了 PubMed、EMBASE、Cochrane 图书馆、Web of Science、中国生物医学文献数据库、中国科学期刊全文数据库和中国期刊全文数据库,以确定相关的原始研究。纳入了任何语言的比较早期乳腺癌患者 APBI 与全乳放疗的随机对照试验。使用 RevMan 5 软件进行统计分析。纳入了四项涉及 919 例患者的试验。两组间 5 年和 7 年优良美容效果的比例有显著差异 {比值比(OR)=2.09 [95%置信区间(CI)=1.21-3.62]}。两组间 5 年和 8 年总生存率无显著差异 [OR=1.76(95%CI=0.67-4.62)和 OR=0.86(95%CI=0.44-1.66)]。两组间 10 年总生存率有显著差异 [OR=0.56(95%CI=0.35-0.91)]。两组间 5 年无局部复发(LR)生存率 [OR=0.65(95%CI=0.18-2.34)]、癌症特异性生存率 [OR=1.67(95%CI=0.39-7.12)]、无病生存率 [OR=0.84(95%CI=0.38-1.84)]、LR [OR=1.36(95%CI=0.46-3.99)]、对侧乳腺癌发生率 [OR=2.82(95%CI=0.73-10.89)] 和远处转移率 [OR=0.71(95%CI=0.22-2.31)] 均无显著差异。APBI 明显提高了乳房任何部位的优良美容效果比例,缩短了治疗时间,减轻了疼痛,提高了生活质量。未来需要开展更大规模、高质量、双盲的试验。