The Study Of Concurrent Endocrine Therapy With Radiotherapy After Breast Cancer Operation Compared With Sequential Endocrine Therapy With Radiotherapy

ObjectiveTo investigate the safety and efficacy of concurrent or sequential radiotherapy and endocrine therapy after breast cancer surgery。Methods1.The clinical efficacy and safety of concurrent or sequential radiotherapy and endocrine therapy were retrospectively analyzed in 63 female patients with breast cancer who received surgical treatment in our hospital from January 2014 to December 2015 and were confirmed by pathological examination to be positive for hormone receptor.According to different time sequence of radiotherapy combined with endocrine therapy,the patients were divided into two groups:radiotherapy concurrent endocrine therapy group(CON group)and radiotherapy sequential endocrine therapy group(SEQ group).The effects of two different time sequence therapy regimens on adverse reactions and prognosis were investigated.2.The database of Pubmed,Cochrane library,Embase,CNKI,wanfa ng,CBM were searched by computer with year of publication between from January 2000 to January 2020.To collect the rel evant research on concurrent versus sequential radiotherapy an d endocrine therapy after breast cancer surgery.According to t he inclusion and exclusion screened the literature,and conduct ed quality evaluation.The meta-analysis was performed by Rev Man 5.3 software and STATA 12.0 software.Results1.There was no significant difference in the incidence of radiation pneumonia,lung fibrosis and skin fibrosis between the corresponding group and the sequential group(P>0.05),and there were no significant differences in recurrence rate,distant metastasis rate and 5-year survival rate between the two groups P>0.05).2.A total of 16 papers were included involving 2677 patients.The results of this study displayed there were no signifificant statistical differences between radiotherapy concurrent with endocrine therapy group(CON group)and radiotherapy sequential with endocrine therapy group(SEQ group)in terms of local recurrence(LR)rate[odds ratio(OR):0.95(95%confidence interval(CI):0.74～1.21),P-0.66]、distant metastasis(DM)rate[OR:0.86(95%CI:0.68～1.09),P=0.22]、5-year overall survival(OS)rate[OR:1.18(95%CI:0.84～1.67),P=0.35]、10-year OS rate[OR:1.06(95%CI:0.78～1.44),P=0.72]、radioactive pulmonary fibrosis(RPF)rate[OR:1,14(95%CI:0.74～1.77),P=0.55]、radiation pneumonitis(RP)rate[OR:1.17(95%CI:0.68～2.01),P=0.56]、radioactive skin fibrosis rate[OR:1.08(95%CI:0.80～1.46),P=0.62].Nationality,surgical method and endocrine therapies were analyzed,and the results showed that there was no statistical differences between CON group and SEQ group based on the local recurrence rate.Conclusion1.After the operation of breast cancer,there was no effect on the adverse reactions by radiotherapy,local recurrence,distant metastasis and 5-year survival rate caused between the simultaneous endocrine therapy and sequential endocrine therapy of radiotherapy.2.This study proves that the efficacy and safety of concurrent endocrine therapy and radiotherapy are similar compared with sequential radiotherapy and endocrine therapy for breast cancer patients after surgery.