| Objective:We conducted a Systematic Review about the effect on the risk of local recurrence and overall survival of radiotherapy after mastectomy for breast cancer with negative,1-3and≥4positive axillary lymph nodes after mastectomy for breast cancer.Meterials and Methods:We used the searching algorithm to search the foreign language databases as PubMed, EMBASE, SCI and the Coehrane Library, and the Chinese databases as CBM, CNKI, Wanfang database, and VIP. The last search was updated on August2011. According with the type of study design, study characteristics, interventions and outcome measures, we considered all eligible RCTs (randomized controlled trials) by comparing radiotherapy after mastectomy with mastectomy only in breast-cancer patients. In addition, we tried to identify previous systematic review and Meta-analysis of randomized trials in this field. Manual searches were done by review articles and abstracts. We use RevMan5.1.0software for statistical analysis. The χ2test is used to compare heterogeneity. Sensitivity analysis is used to evaluate the stability and reliability of the results.Results:A search of six trials totally with4,765patients, including1246patients of negative axillary lymph nodes,2315patients of1-3positive axillary lymph nodes, and1204patients of^4positive axillary lymph nodes.For negative axillary lymph nodes:①We found significant differences associated with10-year locoregional recurrence [RR=0.33,95%CI(0.21,0.52), p<0.00001] between patients with radiotherapy and patients without radiotherapy.②We found no significant difference associated with10-year Overall survival [RR=1.04,95%CI(0.90,1.13),p=0.37] between patients with radiotherapy and patients without radiotherapy.For1-3positive axillary lymph nodes:①We found significant differences associated with10-year locoregional recurrence [RR=0.21,95%CI(0.16,0.28), p<0.00001] between patients with radiotherapy and patients without radiotherapy.②We found significant differences associated with10-year Overall survival [RR=0.36,95%CI(0.15,0.87),p=0.02] between patients with radiotherapy and patients without radiotherapy.For≥4positive axillary lymph nodes:①We found significant differences associated with10-year locoregional recurrence [RR=0.29,95%CI(0.22,0.38),p<0.00001] between patients with radiotherapy and patients without radiotherapy.②We found significant differences associated with10-year Overall survival [RR=1.18,95%CI(1.10,1.26), p<0.00001] between patients with radiotherapy and patients without radiotherapy.Conclusions:1. For negative axillary lymph nodes after mastectomy, study showed a significant reduction of10-year locoregional recurrences after post-mastectomy radiotherapy. No significant differences were found in 10-year overall survival.2. For1-3positive axillary lymph nodes after mastectomy, study showed a significant reduction of10-year loco-regional recurrences after post-mastectomy radiotherapy, and a steady improvement of10-year overall survival.3. For≥4positive axillary lymph nodes after mastectomy, study showed a significant reduction of10-year loco-regional recurrences after post-mastectomy radiotherapy, a steady improvement of10-year overall survival. Objective:We conducted a Systematic Review the effect on the risk of local recurrence, overall survival, cosmetic results and radiation damage of hypofractionated whole breast radiotherapy after breast-conserving surgery (BCS) for early breast cancer.Meterials and Methods:We used the searching algorithm to search the foreign language databases as PubMed, EMBASE, SCI and the Coehrane Library, and the chinese databases as CBM, CNKI,Wanfang database, and VIP. The last search was updated on August2011. In accordance with the type of study design, study characteristics, interventions and outcome measures, we considered eligible all randomized controlled trials or controlled clinical trials comparing hypofractionated whole-breast radiotherapy with conventional whole-breast radiotherapy after BCS in patients with early breast cancer.In addition, we tried to identify any previous systematic review and Meta-analysis of randomized trials in this.Manual searches were done by reviewing articles and abstracts. We use RevMan5.1.0software for statistical analysis. The%test is used to compare hetero-geneity. Sensitivity analysis is used to evaluate the stability and reliability of the results.Results:A search of four trials with pooled total of5,884patients.①We found no significant difference associated with5-years and10-year ipsilateral breast cancer recurrence (p=0.16,p=0.27) between patients with hypofraction-ated and conventional whole-breast radiotherapy.②We found no significant difference associated with5-year overall survival (p=0.09) between patients with hypofraction-ated and conventional whole-breast radiotherapy.③We found no significant differenc associated with5-year long-term radiation damage:any change in breast appearance (p=0.95), ischaemic heart disease (p=0.08), symptomatic lung fibrosis (p=0.39), symptommatic rib fracture (p=0.90) between patients with hypofraction-ated and conventional whole-breast radiotherapy.③We found no significant differences associated with5-year and10-year the cosmetic results of excellent/good (p=0.64, p=0.73) between patients with hypofractionated and conventional whole-breast radiotherapy.Conclusions:No significant differences were found in psilateral breast cancer recurrence, overall survival, long-term radiation damage:any change in breast appearance, ischaemic heart disease, symptomatic lung fibrosis, symptomatic rib fracture, and the cosmetic results of excellent/good between patients with hypofractionated and conventional whole-breast radiotherapy. Objective:We conducted a Systematic Review the effect on the risk of local recurrence, overall survival, cosmetic results and radiation damage of partial breast irradiation (PBI) after breast-conserving surgery (BCS) for early breast cancer.Meterials and Methods:We used the searching algorithm to search the foreign language databases as PubMed, EMBASE, SCI and the Coehrane Library, and the chinese databases as CBM, CNKI,Wanfang database, and VIP. The last search was updated on August2011. In accordance with the type of study design, study characteristics, interventions and outcome measures, we considered eligible all randomized controlled trials or controlled clinical trials comparing PBI with whole-breast irradiation (WBI) after breast-conserving surgery in patients with early breast cancer. In addition, we tried to identify any previous systematic review and Meta-analysis of randomized trials in this.Manual searches were done by reviewing articles and abstracts. We use RevMan5.1.0software for statistical analysis. The χ2test is used to compare heterogeneity. Sensitivity analysis is used to evaluate the stability and reliability of the results.Results:A search of four trials with pooled total of955patients.①We found no significant differences associated with5-year,7-year,8-year and10-year ipsilateral breast cancer recurrence (p=0.65,p=0.54, p=0.0S,p=0.74) between patients with PBI and WBI. ②We found no significant differences associated with5-year and10-year contralateral breast cancer (p=0.13,p=0.14) between patients with PBI and WBI.③We found no significant differences associated with5-year and8-year overall survival (p=0.35,p=0.65) between patients with PBI and WBI.④However, We found significant differences associated with cosmetic results of5-year and7-year excellent/good [RR=1.23,95%CI(1.04,1.46), p=0.0l; RR=1.27,95%CI(1.02,1.57),1=0.03] between patients with with PBI and WBI.Conclusions:1. No significant differences were found in ipsilateral breast cancer recurrence, contralateral breast cancer, and overall survival between patients with PBI and WBI.2. PBI was statistically significantly associated with an increased the cosmetic results of excellent/good. |
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