The effect of postmastectomy radiotherapy after neoadjuvant chemotherapy in patients with breast cancer: a meta-analysis.

BACKGROUND

Recent advancements in NAC efficacy have sparked considerable debate regarding the role of postmastectomy radiation therapy (PMRT) in breast cancer treatment.

METHODS

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.

RESULTS

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).

CONCLUSION

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.