Efficacy and Safety of Accelerated Partial Breast Irradiation after Breast-conserving Surgery: A Meta-analysis of Published Comparative Studies
A partir d'une revue de la littérature publiée jusqu'en juillet 2012 (11 études comparatives, 7 097 patientes), cette méta-analyse compare l'efficacité, du point de vue de la récidive locale, de la survenue de métastases distantes et de la survie, et la sécurité d'une irradiation accélérée partielle du sein et d'une irradiation du sein entier chez les patientes ayant subi un traitement chirurgical conservateur
To compare the treatment outcomes between accelerated partial breast irradiation (APBI) and conventional whole-breast irradiation (WBI) and to explore the efficacy and safety of APBI as an adjuvant treatment for early-stage breast cancer who received breast-conserving therapy. Eligible studies were identified on Medline, Embase, and the Cochrane Library updated to July 10, 2012. Comparative studies were considered for inclusion. Analyses were carried out using Stata software. Eleven comparative studies with a total of 7,097 patients were included. The meta-analysis showed that there were no statistically significant differences between group APBI and group WBI associated with the supraclavicular failure, distant metastasis, overall survival, and disease-free survival, while local recurrence (LR) and axillary failure (AF) increased in group APBI. The sensitivity analysis indicated that both the LR and AF were not statistically significant difference between the two groups. In the subgroup analysis, LR was statistically significantly higher in group APBI for patients with the age <60, large tumor size, and unknown margin status. APBI is a safe treatment modality and could become a potential option for the delivery of adjuvant radiation therapy in patients receiving breast-conserving therapy, especially for the suitable group that was classified by the American Society of Radiation Oncology Consensus Panel.