| 马飞霞,蒋帅,胡袁媛,顾锡冬,谢小红.乳腺交界性及恶性叶状肿瘤术后放疗的治疗价值荟萃分析[J].浙江中西医结合杂志,2020,30(1): |
| 乳腺交界性及恶性叶状肿瘤术后放疗的治疗价值荟萃分析 |
| Postoperative radiotherapy for borderline and malignant phyllodes tumors of the breast：A meta-analysis |
| 投稿时间：2019-03-28 修订日期：2019-11-10 |
| DOI： |
| 中文关键词: 乳腺叶状肿瘤 放疗 局部复发率 无病生存率 总生存率 荟萃分析 |
| 英文关键词:Phyllodes tumor Radiotherapy Local recurrence Disease-free survival Overall survival Meta-analysis |
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| 摘要点击次数: 871 |
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| 中文摘要: |
| 目的 通过荟萃分析研究术后放疗对乳腺交界性及恶性叶状肿瘤患者预后的影响。方法 搜索Pubmed、Web of Science、中国知网等数据库,并辅以手工检索,根据纳入排除标准,查找有关术后放疗在乳腺交界性及恶性叶状肿瘤患者中的治疗价值的文献,由2名研究者独立评价文献并获取数据,以局部复发率、无病生存率(disease-free survival,DFS)、总生存率(overall survival,OS)为主要评价指标,应用RevMan 5.2版软件进行荟萃分析。结果 来自9项研究的5880例乳腺恶性及交界性叶状肿瘤患者纳入本次荟萃分析,结果显示术后放疗可显著降低患者5年局部复发率(RR=0.44,95%CI=[0.27-0.74],P=0.002),提高5年DFS(RR=0.75,95%CI=[0.56-0.99],P=0.05),而对OS并无显著影响(RR=1.28,95%CI=[0.99-1.66])。亚组分析提示保乳手术患者行放疗可明显提高局部控制率(RR=0.29,95%CI=[0.12-0.72],P=0.007),但对DFS及OS并无显著影响。而放疗对于单乳切除患者来说均无明显获益。结论 术后辅助放疗可显著降低乳腺恶性及交界性叶状肿瘤局部复发率,保乳患者获益更为明显,同时放疗可一定程度上提高患者5年DFS,但对OS并无显著影响。 |
| 英文摘要: |
| Obejective To evaluate the impact of postoperative radiotherapy for borderline and malignant phyllodes tumors of the breast by a meta-analysis. Methods A search was performed in Pubmed, Web of Science and China National Knowledge Infrastructure (CNKI) databases for eligible studies according to the inclusion and exclusion criteria. Local recurrence, disease-free survival(DFS), overall survival(OS) were the main endpoints. And RevMan v5.2 was applied to analyze the results. Results Totally nine studies involving 5880 patients were included for final analysis. Postoperative radiotherapy had advantages in aspects of controlling local recurrence (RR=0.44,95%CI=[0.27-0.74],P=0.002) and increasing 5-year DFS (RR=0.75,95%CI=[0.56-0.99],P=0.05), but not in OS(RR=1.28,95%CI=[0.99-1.66]). Furthermore patients undergoing breast-conserving surgery could significantly benefit from radiotherapy in reducing the risk of local recurrence (RR=0.29,95%CI=[0.12-0.72],P=0.007) while patients undergoing total mastectomy got no benefit in any aspects mentioned above. Conclusion Postoperative radiotherapy for patients with borderline and malignant phyllodes tumors of the breast will significantly decrease the rate of local recurrence especially for patients undergoing breast-conserving surgery. And it can increase 5-year DFS to some degree but make no difference to OS. |
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