早期乳腺癌保乳术后加速部分乳腺放疗的Meta分析  

Meta Analysis on Accelerated Partial Breast Irradiation Following Breast-conserving Surgery for Patients with Early Stage Breast Cancer

作　　者：张秋宁[1] 王强 冶秀鹏[1,3] 王小虎[1] 田金徽[3] 杨克虎[3] 马文[4] 罗宏涛[1] 刘锐锋[1] 郭丽云[1,3] 刘楠[1] 冯石芳[1] 

机构地区：[1]甘肃省肿瘤医院,甘肃兰州730050 [2]中卫市第二人民医院,宁夏中卫755000 [3]兰州大学循证医学中心,甘肃兰州730000 [4]甘肃省人民医院,甘肃兰州730000

出　　处：《肿瘤学杂志》2011年第7期524-529,共6页Journal of Chinese Oncology

基　　金：甘肃省研究与开发专项(1004TCYA006);甘肃省重离子等射线治疗肿瘤科技创新团队(2009GSO2785)

摘　　要：[目的]评价早期乳腺癌保乳术后加速部分乳腺放射治疗(APBI)的疗效。[方法]计算机检索PubMed、CochraneLibrary、SCI、EMBASE、中文科技期刊全文数据库、中国期刊全文数据库、数字化期刊全文数据库和中国生物医学文献数据库,并辅手工检索和其他检索。纳入比较早期乳腺癌保乳术后APBI与全乳腺放疗(WBRT)的临床对照试验,根据Cochrane系统评价手册5.0.0质量评价标准进行质量评价,使用RevMan5.0软件进行Meta分析。[结果]共纳入4个研究(919例患者)。Meta分析显示:与WBRT相比,APBI后10年总生存率有差异(OR=0.56,95%CI:0.35～0.91),而5、8年总生存率方面无差异(OR=1.76,95%CI:0.67～4.62;OR=0.86,95%CI:0.44～1.66);在5、7年绝对美容满意率方面有差异(OR=2.09,95%CI:1.21～3.62,P=0.009;OR=3.42,95%CI:1.25～9.38,P=0.02),两者5年无复发生存率,肿瘤专项生存率、5年无病生存率,局部复发率、对侧乳腺癌发生率、远处转移率方面均无差异。[结论]APBI是一种可行的早期乳腺癌治疗方式,其明显缩短了疗程,美容效果较好,提高了患者的生活质量。[Purpose] To assess the response of accelerated partial breast irradiation（APBI） following breast-conserving surgery for patients with early stage breast cancer. [Methods] The randomized controlled trials in PubMed, Cochrane Library, SCI, EMBASE, Chinese Biomedical Database, Chinese Studies Online, Chinese Scientific Journals Full-text Database, China Journal Full-text Database were searched, and manual search and other search were supplemented. The controlled clinical trials of APBI or whole breast radiotherapy （WBRT） following breast-conserving surgery for early stage breast cancer were enrolled. Quality assessment and data extraction were done by two reviewers independently according to the Cochrane Reviewer’s handbook 5.0.0. Meta-analyses were performed on the results of homogenous studies by RevMan5.0. [Results] Four trials （919 patients） were enrolled. The Meta analysis results showed that： The 10-year overall survival was significantly different between the WBRT and APBI group （OR=0.56,95%CI：0.35～0.91）, and the 5,8-year overall survival was not significantly different （OR=1.76, 95%CI：0.67～4.62; OR=0.86, 95%CI：0.44～1.66）. The 5,7-year excellent/good cosmetic rate was significantly different between the 2 groups（OR=2.09,95%CI：1.21～3.62,P=0.009; OR=3.42,95%CI：1.25～9.38,P=0.02）. There was no significant difference of the 5-year relapse-free survival, cancer-specific survival, 5-year disease-free survival, local recurrence rate, the incidence of contralateral breast cancer and distant metastasis rate between the 2 groups.[Conclusion] APBI for early stage breast cancer is effective. It can shorten the treatment time, improve excellent/good cosmetic rate and improve quality of life in patients with breast cancer.

关 键 词：乳腺肿瘤 保乳术 加速部分乳腺放疗 全乳腺放疗 META分析 

分 类 号：R737.9[医药卫生—肿瘤]