摘要
目的Meta分析乳腺癌患者内乳淋巴结预防性照射的疗效。方法计算机检索中国知网、万方医学网、中国生物医学文献数据库、PubMed、EMBASE、Web of science。纳入比较以内乳淋巴结照射与否为干预措施的临床对照研究,按照Newcastle-Ottawa Scale量表进行纳入文献的质量评价。采用RevMan5.3软件和Stata14软件进行Meta分析。结果共纳入11篇原始文献,13181例患者进行Meta分析。与内乳未照射患者相比,内乳照射患者5年总生存未见改变(P=0.490)。通过以患者治疗日期以及入组人群风险程度为划分标准进行亚组分析显示,于2000年后治疗和入组条件为Ⅱ-Ⅲ期(N+、T_(3)-T_(4)期)高风险患者内乳照射后5年总生存明显提高(P=0.003、0.006)。与内乳未照射患者相比,内乳照射明显提高患者5年无瘤生存(P<0.001)。结论在现代放疗技术下,乳腺癌内乳淋巴引流区照射提高了患者无瘤生存率,并且可能会对Ⅱ-Ⅲ期(N+、T_(3)-T_(4)期)高风险乳腺癌患者带来总生存益处。
Objective To evaluate the effect of prophylactic irradiation of internal mammary lymph nodes in patients with breast cancer in this Meta-analysis.Methods CNKI,Wanfang Medical network.CBM,PubMed,EMBASE and Web of Science were searched by computer.The controlled clinical studies comparing whether or not internal mammary lymph node irradiation as an intervention were included and the quality of the included literature was evaluated according to Newcastle-Ottawa Scale(NOS).RevMan 5.3 software and Stata 14 software were used for Meta-analysis.Results A total of 11 original articles were included,and 13181 patients were included for Meta-analysis.There was no statistically significant difference in the overall survival(OS)between patients with and without internal mammary lymph node irradiation(P=0.490).The subgroup analysis using the date of treatment and the degree of risk in the enrolled population as criteria showed that 5-year OS was significantly increased after internal mammary area irradiation in high-risk stage U-HI patients(N+,T_(3)-T_(4) stage)with the date of treatment of after 2000(P=0.003,0.006).Compared with patients without internal mammary area irradiation,intenial mammary irradiation significantly increased the 5-year disease-free survival(DFS)(P<0.001).Conclusion Under the modem radiotherapy technology,internal mammary lymph node irradiation improves the DFS of patients,and may bring OS benefits to high-risk stage D-ID breast cancer patients(N+,T_(3)-T_(4) stage).
作者
贾思聪
刘志坤
张钧
赵晨光
朱龙玉
孔洁
韩慧娜
尚宇光
申东星
段学娟
Jia Sicong;Liu Zhikun;Zhang Jun;Zhao Chenguang;Zhu Longyu;Kong Jie;Han Huina;Shang Yuguang;Shen Dongxing;Duan Xuejuan(Department of Radiation Oncology,Fourth Hospital of Hebei Medical University/Hebei Cancer Hospital.Shijiazhuang 050011,China;Department of Internal Medicine,Fourth Hospital of Hebei Medical University/Hebei Cancer Hospital,Shijiazhuang 050011,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2021年第9期903-909,共7页
Chinese Journal of Radiation Oncology
关键词
乳腺肿瘤/放射疗法
内乳淋巴结
荟萃分析
Breast neoplasm/radiotherapy
Internal mammary lymph node:Meta-analysis