Zou Aishan, Li Liuyi, Guo Yang, Zhang Cuiwei
Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, P.R. China.
Clinical Medicine School of Southwest Medical University, Luzhou, P.R. China.
Future Oncol. 2025 Jun;21(15):1929-1938. doi: 10.1080/14796694.2025.2505372. Epub 2025 Jun 2.
Recent advancements in NAC efficacy have sparked considerable debate regarding the role of postmastectomy radiation therapy (PMRT) in breast cancer treatment.
A comprehensive search of PubMed, Embase, and Cochrane databases was conducted to identify all relevant studies examining the prognostic significance of PMRT in breast cancer patients. The incidence of adverse events was aggregated to determine the correlation between PMRT and patient survival outcomes.
The current meta-analysis included 15 eligible studies. Patients who received PMRT numbered 42,289, while 23,199 did not receive these treatments. No significant difference was observed between PMRT and OS (pooled RR 0.93; 95% CI 0.83-1.04) or DMFS (pooled RR 1.12; 95% CI 0.99-1.28) in predicting breast cancer outcomes. PMRT was associated with improved DFS in patients with lymphovascular invasion (LVI) (pooled RR 0.33; 95% CI 0.19-0.57). The meta-analysis found no significant correlation between PMRT and OS in patients with pathological complete remission (pCR) (HR 0.86; 95% CI 0.68-1.07).
No significant difference was observed between PMRT and OS. While PMRT did not improve overall survival in the entire group, our subgroup analyses suggest selective benefit for non-pCR or LVI positive patients. These findings may aid in the clinical decision-making process.
NAC疗效的最新进展引发了关于乳房切除术后放疗（PMRT）在乳腺癌治疗中作用的广泛争论。
对PubMed、Embase和Cochrane数据库进行全面检索，以确定所有研究PMRT对乳腺癌患者预后意义的相关研究。汇总不良事件的发生率，以确定PMRT与患者生存结局之间的相关性。
当前的荟萃分析纳入了15项符合条件的研究。接受PMRT的患者有42289例，而未接受这些治疗的患者有23199例。在预测乳腺癌结局方面，PMRT与总生存期（合并RR 0.93；95%CI 0.83 - 1.04）或无远处转移生存期（合并RR 1.12；95%CI 0.99 - 1.28）之间未观察到显著差异。PMRT与血管淋巴管浸润（LVI）患者的无病生存期改善相关（合并RR 0.33；95%CI 0.19 - 0.57）。荟萃分析发现，病理完全缓解（pCR）患者中PMRT与总生存期之间无显著相关性（HR 0.86；95%CI 0.68 - 1.07）。
PMRT与总生存期之间未观察到显著差异。虽然PMRT并未改善整个组的总生存期，但我们的亚组分析表明对非pCR或LVI阳性患者有选择性益处。这些发现可能有助于临床决策过程。
