Local recurrence after whole breast irradiation combined with tumor bed boost in patients with breast ductal carcinoma in situ after breast-conservingsurgery: A Meta-analysis / 肿瘤

ABSTRACT

Objective: To conduct a Meta-analysis to analyze the short-term and long-term preventive effects of whole breast irradiation combined with tumor bed boost on short- and long-term local recurrence rates and local recurrence rate of ipsilateral invasive breast cancer in patients with breast ductal carcinoma in situ (DCIS) after breast conserving-surgery (BCS). Methods: A computer-based online search of PubMed, China Journal Full-text Database (CJFD), China Biology Medicine disc (CBMdisc), Embase and Cochrane Library was performed to include eligible studies in accordance with the inclusion and exclusion criteria. Newcastle Ottawa Quality Assessment Scale was used for quality assessment of included articles. RevMan 5.3 software was used for Meta-analysis. Results: A total of 14 non-randomized controlled trials (13 were cohort study, and 1 was nonsimultaneous controlled trial) involving 8679 patients with breast DCIS were included. The results of this Meta-analysis showed that no statistically significant differences between whole breast irradiation and whole breast irradiation combined with tumor bed boost in terms of 5-year local recurrence rate [odds ratio (OR) = 0.92, 95% confidence interval (CI) 0.46-1.82; P = 0.81], 7-year local recurrence rate (OR = 0.70, 95% CI 0.45-1.09; P = 0.11), ≥ 10-year local recurrence rate (OR = 0.95, 95% CI 0.79-1.15; P= 0.62) and the local recurrence rate of ipsilateral invasive breast cancer (OR = 0.89, 95% CI 0.62-1.29; P = 0.55). Conclusion: As compared with whole breast irradiation, the whole breast irradiation combined with tumor bed boost in patients with DCIS after BCS can not obviously decrease the 5-year, 7-year and ≥ 10-year local recurrence rates, as well as the local recurrence rate of ipsilateral invasive breast cancer.