Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China.
Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China.
BMC Cancer. 2019 Apr 23;19(1):372. doi: 10.1186/s12885-019-5585-5.
As the efficacy of radiotherapy and chemotherapy for treatment of phyllodes tumors (PTs) remains unclear, this study aimed to review all available data and evaluate the roles of radiotherapy and chemotherapy in PT treatment.
We performed a comprehensive search of databases, including PubMed, Web of Science and the Cochrane Library. The outcomes of interest included the local recurrence (LR) rate, metastasis rate, disease-free survival rate and overall survival rate.
Seventeen studies enrolling 696 patients were included in this random effect meta-analysis. Subgroup analysis and meta-regression were also conducted to determine study heterogeneity. A pooled local recurrence rate of 8% (95% CI: 1-22%) was observed with a statistical heterogeneity of I = 86.6% (p < 0.01) for radiotherapy. This was lower than the recurrence rate of 12% for simple surgical treatment (95% CI: 7-18%). Meta-regression analysis found that surgical margin status was the main source of heterogeneity (p = 0.04). The metastasis rate of 4% (95% CI: 0-11%) for patients receiving radiotherapy without significant heterogeneity was also lower than the rate for the simple surgery group (8, 95% CI: 3-15%). The available data for chemotherapy were too limited to support meta-analysis. Accordingly, we offer a pure review of these data.
Our findings suggest that radiotherapy is effective in achieving local disease control and preventing metastasis.
由于放疗和化疗治疗叶状肿瘤（PTs）的疗效仍不清楚，本研究旨在回顾所有可用数据并评估放疗和化疗在 PT 治疗中的作用。
我们对包括 PubMed、Web of Science 和 Cochrane Library 在内的数据库进行了全面搜索。感兴趣的结局包括局部复发（LR）率、转移率、无疾病生存率和总生存率。
这项随机效应荟萃分析纳入了 17 项研究共 696 例患者。还进行了亚组分析和荟萃回归以确定研究异质性。放疗的局部复发率为 8%（95%CI：1-22%），异质性 I = 86.6%（p < 0.01）。这低于单纯手术治疗的 12%（95%CI：7-18%）复发率。荟萃回归分析发现手术切缘状态是异质性的主要来源（p = 0.04）。接受放疗且无明显异质性的患者转移率为 4%（95%CI：0-11%），也低于单纯手术组（8%，95%CI：3-15%）。化疗的可用数据太有限，无法支持荟萃分析。因此，我们对这些数据进行了纯回顾。
我们的研究结果表明，放疗在实现局部疾病控制和预防转移方面是有效的。
