大分割放疗在术后早期乳腺癌患者中的系统评价及Meta分析

发布时间：2018-05-30 03:41

本文选题：早期乳腺癌 + 大分割放疗　；参考：《广西医科大学》2015年硕士论文

【摘要】：背景与目的：术后放疗是早期乳腺癌的标准治疗方式之一。然而,放射治疗的最佳分割模式还存在许多的争议,我们写该meta分析的目的是相互对比大分割放疗(HRT)和常规分割放疗(CRT)在术后早期乳腺癌患者中的疗效。因此,我们在随机对照试验的基础上进行了该meta分析,评价常规分割放疗和大分割放疗对于术后早期乳腺癌患者的作用。方法：由两位独立的作者全面地检索Pubmed、Cochrane Central Trials Registry, Medline, Web of Science和相关期刊论文。纳入文献限制在早期乳腺癌患者的随机对照实验中,主要的观察指标为：总体生存率(OS)、3-5年和10年的局部复发率(LR)、远处复发率(DR)和乳房外形变化。本Meta分析运用的是Review manager5.0版本,并且使用OR相对应的95%的可信区间(CI)来代表结果。结果：本meta分析纳入5项随机对照研究总共8009例早期乳腺癌患者。经分析显示与常规分割放疗对比,大分割放疗在3-5年局部复发率(OR=0.98,95% CI区间：0.79-1.20,P=0.82)、10年局部复发率(OR=0.96,95% CI区间：0.81-1.14,P=0.65)、远处复发(OR= 1.10,95% CI区间：0.75-1.62,P=0.61)、总体生存率(OR=1.08,95% CI:区间0.93-1.26,P=0.32)方面几乎相似,无统计学意义。在保乳术后乳房外形变化的亚组分析中显示,分次剂量3.3Gy的大分割放疗组无统计学差异(OR=1.05,95% CI：0.74-1.49,P=0.79),然而,分次剂量"g3.3Gy的大分割放疗组(OR=1.48,95% CI:1.09-2.01, P= 0.01),差异有统计学意义,说明分次剂量"g3.3Gy的大分割放疗组增加保乳术后早期乳腺癌患者乳房外形的变化。结论：该研究是关于术后早期乳腺癌患者使用大分割放射治疗的安全性和有效性的meta分析。通过本研究表明分次剂量"g3.3Gy的大分割放疗组在保乳术后早期乳腺癌患者中增加了乳房外形的变化,然而在总体生存率、远处复发、3～5年和10年局部复发率没有差别。
[Abstract]:Background and purpose: postoperative radiotherapy is one of the standard treatments for early breast cancer. However, there are many controversies in the best segmentation mode of radiotherapy. The purpose of this meta analysis is to compare the efficacy of large fractionation radiotherapy (HRT) and conventional fractionated radiotherapy (CRT) in the early postoperative breast cancer patients. Therefore, we are at random The meta analysis was conducted on the basis of the controlled trial to evaluate the role of conventional fractionated radiotherapy and large fractionated radiotherapy for early postoperative breast cancer patients. Methods: two independent authors were fully retrieved Pubmed, Cochrane Central Trials Registry, Medline, Web of Science, and the full text database of Chinese periodicals. In the randomized controlled trial of patients with breast cancer, the main indicators were the overall survival rate (OS), the local recurrence rate (LR) in 3-5 and 10 years, the distant recurrence rate (DR) and the change of the breast shape. The Meta analysis used the Review manager5.0 version, and the 95% confidence interval (CI) corresponding to the OR phase was used to represent the results. A total of 8009 patients with early breast cancer were analyzed in 5 randomized controlled studies. Compared with conventional fractionation radiotherapy, the local recurrence rate (OR=0.98,95% CI interval: 0.79-1.20, P=0.82), 10 year local recurrence rate (OR=0.96,95% CI interval: 0.81-1.14, P=0.65), and distant recurrence (OR= 1.10,95% CI interval: 0.75-1.) were compared with conventional fractionated radiotherapy. 62, P=0.61), the overall survival rate (OR=1.08,95% CI: interval 0.93-1.26, P=0.32) was almost similar, without statistical significance. In subgroup analysis of breast shape changes after breast conserving surgery, there was no statistical difference in the fractionated dose 3.3Gy large fractionated radiotherapy group (OR=1.05,95% CI: 0.74-1.49, P=0.79), however, the fractionated dose "g3.3Gy large fractionation radiotherapy" Group (OR=1.48,95% CI:1.09-2.01, P= 0.01), the difference was statistically significant, indicating that the fractionated dose of "g3.3Gy" in large fractionation radiotherapy group increased breast shape changes in early breast cancer patients after breast conserving surgery. Conclusion: This study is a meta analysis of the safety and effectiveness of early postoperative breast cancer patients using large segmented radiotherapy. The study showed that the fractionated dose of "g3.3Gy 'large fractionated radiotherapy group increased breast shape changes in early breast cancer patients after breast conserving surgery, but there was no difference in the overall survival rate, distant recurrence, and 3~5 and 10 year local recurrence rates.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R737.9

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