Post-Mastectomy Radiotherapy for Breast Cancer Patients with T1-T2 and 1-3 Positive Lymph Nodes: a Meta-AnalysisReportar como inadecuado




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Background

The role of post-mastectomy radiotherapy PMRT in patients with T1-2 and 1-3 positive lymph nodes remains controversial. The aim of this study is to investigate the possible benefits of PMRT for this subgroup.

Methods

Three electronic databases were systematically quarried Cochrane Library, MEDLINE, and EMBASE for published studies evaluating the effects of PMRT on breast cancer patients with T1-T2 tumors with 1-3 positive lymph nodes. Of the 334 studies identified, information was available for 3432 patients from 10 clinical studies. Pooled relative risk estimates RR and overall survival OS were calculated using the inverse variance weighted approach, publication bias and chi-square test were also calculated.

Results

From the 10 studies, the pooled RR RRs for locoregional recurrence LRR with PMRT was 0.348 95% CI = 0.254 to 0.477, suggesting a significant benefit for PMRT to decrease the risk of LRR in patients with T1-T2 tumors and 1-3 positive nodes p<0.05. Reporting bias Begg’s p = 0.152; Egger’s p = 0.107 or significant heterogeneity Cochran’s p = 0.380; I2 = 6.7% were not detected. For further subset analysis, the RR for T1, N1-3+ tumors was 0.330 95% CI = 0.171 to 0.639; for T2, N1-3+ tumors the RR was 0.226 95% CI = 0.121 to 0.424. The pooled RR for overall survival OS was not significantly different between PMRT and no-PMRT group 1.051, 95% CI =1.001 to 1.104.

Conclusions

Our pooled analysis revealed that PMRT significantly reduces the risk of LRR in patients with TI-T2 tumors with 1-3 positive nodes, and the magnitude of the LRR risk reduction is slightly greater for larger tumors. Our results suggest that PMRT should be considered for patients with T1-T2 tumors with 1-3 positive nodes to decrease the relatively high risk of LRR.



Autor: Yaming Li, Meena S. Moran, Qiang Huo, Qifeng Yang , Bruce G. Haffty

Fuente: http://plos.srce.hr/



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