Department of Radiation Oncology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu, 322000, Zhejiang, People's Republic of China.
Department of General Medicine, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu, 322000, Zhejiang, People's Republic of China.
Breast Cancer. 2020 Mar;27(2):299-307. doi: 10.1007/s12282-019-01023-9. Epub 2019 Nov 9.
This meta-analysis evaluates the difference in deep inspiration breath hold (DIBH) versus free breathing (FB) for patients receiving postoperative radiotherapy for left breast cancer and provides a useful reference for clinical practice.
The relevant controlled trials of DIBH versus FB in postoperative radiotherapy for left-side breast cancer were retrieved from the databases of PubMed, Science Direct, Cochrane Library, and Web of Science databases. The principal outcome of interest was heart dose, left anterior descending coronary artery (LADCA) dose, and left lung dose and target coverage. We calculated summary standardized mean difference (SMD) and 95% confidence intervals (CI). The meta-analysis was performed using RevMan 5.3 software.
The analysis included 1019 patients from 12 observational studies, of which 576 cases were in the DIBH group and 443 cases in the FB group. Compared with the FB group, the DIBH group can have lower heart dose, left anterior descending coronary artery (LADCA) dose, and left lung dose more effectively, and the difference was statistically significant (heart dose, SMD = - 1.36, 95% CI - 1.64 ~ - 1.09, P < 0.01. LADCA dose, SMD = - 1.45, 95% CI - 1.62 ~ - 1.27, P < 0.01. Left lung dose, SMD = - 0.52, 95% CI - 0.81 ~ - 0.23, P < 0.01). There was no significant difference in target coverage between the two groups (SMD = 0.03, 95% CI - 0.11 ~ 0.18, P = 0.64).
By this meta-analysis, we found that implementation of DIBH in postoperative radiotherapy for left-side breast cancer can reduce irradiation of heart dose, LADCA dose and left lung dose, without compromising target coverage.
本荟萃分析评估了左侧乳腺癌术后放疗中深吸气屏气（DIBH）与自由呼吸（FB）的差异，并为临床实践提供了有用的参考。
从 PubMed、Science Direct、Cochrane Library 和 Web of Science 数据库中检索到 DIBH 与左侧乳腺癌术后 FB 放疗的相关对照试验。主要观察指标是心脏剂量、左前降支冠状动脉（LADCA）剂量和左肺剂量及靶区覆盖。我们计算了汇总标准化均数差（SMD）和 95%置信区间（CI）。使用 RevMan 5.3 软件进行荟萃分析。
该分析纳入了 12 项观察性研究的 1019 例患者，其中 DIBH 组 576 例，FB 组 443 例。与 FB 组相比，DIBH 组能更有效地降低心脏剂量、左前降支冠状动脉（LADCA）剂量和左肺剂量，差异具有统计学意义（心脏剂量，SMD =-1.36，95%CI-1.64-1.09，P<0.01。LADCA 剂量，SMD=-1.45，95%CI-1.62-1.27，P<0.01。左肺剂量，SMD=-0.52，95%CI-0.81-0.23，P<0.01）。两组间靶区覆盖率无显著差异（SMD=0.03，95%CI-0.110.18，P=0.64）。
通过这项荟萃分析，我们发现左侧乳腺癌术后放疗中实施 DIBH 可降低心脏剂量、LADCA 剂量和左肺剂量的照射，而不影响靶区覆盖。
