中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2015年
8期
598-602
,共5页
张秋宁%吕青芳%刘锐锋%田金徽%杨碎胜%魏世鸿%罗宏涛%白晓蓉%包蔚郁
張鞦寧%呂青芳%劉銳鋒%田金徽%楊碎勝%魏世鴻%囉宏濤%白曉蓉%包蔚鬱
장추저%려청방%류예봉%전금휘%양쇄성%위세홍%라굉도%백효용%포위욱
乳腺癌%腋淋巴结%放疗%疗效%Meta分析
乳腺癌%腋淋巴結%放療%療效%Meta分析
유선암%액림파결%방료%료효%Meta분석
Breast cancer%Axillary lymph nodes%Radiotherapy%Efficacy%Meta-analysis
目的 评价乳腺癌(改良)根治术后1～3个腋淋巴结阳性的T1～T2期患者放射治疗的疗效.方法 检索国内外相关数据库,以主题词和自由词相结合查阅相关文献.按照Cochrane 系统评价手册5.2质量评价标准,对纳入文献的方法学进行质量评价,用RevMan5.2软件进行Meta分析.结果 纳入乳腺癌(改良)根治术后1～3个腋淋巴结阳性的T1 ～ T2期患者,共14个研究,4 643例患者.其中,术后放疗组2 080例,术后未放疗组2 563例.与术后未放疗组相比,术后放疗组可以提高总生存率(OR 1.89,95％ CI 1.55 ～2.31,P＜0.05)及无病生存率(OR 2.16,95％CI1.80 ～2.60,P＜0.05),且降低了局部区域复发率(OR0.22,95％ CI0.16 ～0.30,P＜0.05)及远处转移率(OR0.57,95％ CI0.35 ～0.94,P＜0.05).以年龄及肿瘤的大小进行亚组分析,＜40岁和≥40岁的患者局部区域复发率差异有统计学意义(OR 0.15,95％CI0.05 ～0.48;OR0.33,95％ CI0.13 ～0.80,P＜0.05),术后放疗对T1及T2患者均有益(OR 0.48,95％CI 0.24～0.96;OR 0.53,95％CI0.32 ～0.89,P＜0.05).结论 乳腺癌术后1～3个腋淋巴结阳性的T1 ～ T2期患者放疗可以提高总的生存率及无病生存率,并且降低局部区域的复发率及远处转移率.
目的 評價乳腺癌(改良)根治術後1～3箇腋淋巴結暘性的T1～T2期患者放射治療的療效.方法 檢索國內外相關數據庫,以主題詞和自由詞相結閤查閱相關文獻.按照Cochrane 繫統評價手冊5.2質量評價標準,對納入文獻的方法學進行質量評價,用RevMan5.2軟件進行Meta分析.結果 納入乳腺癌(改良)根治術後1～3箇腋淋巴結暘性的T1 ～ T2期患者,共14箇研究,4 643例患者.其中,術後放療組2 080例,術後未放療組2 563例.與術後未放療組相比,術後放療組可以提高總生存率(OR 1.89,95％ CI 1.55 ～2.31,P＜0.05)及無病生存率(OR 2.16,95％CI1.80 ～2.60,P＜0.05),且降低瞭跼部區域複髮率(OR0.22,95％ CI0.16 ～0.30,P＜0.05)及遠處轉移率(OR0.57,95％ CI0.35 ～0.94,P＜0.05).以年齡及腫瘤的大小進行亞組分析,＜40歲和≥40歲的患者跼部區域複髮率差異有統計學意義(OR 0.15,95％CI0.05 ～0.48;OR0.33,95％ CI0.13 ～0.80,P＜0.05),術後放療對T1及T2患者均有益(OR 0.48,95％CI 0.24～0.96;OR 0.53,95％CI0.32 ～0.89,P＜0.05).結論 乳腺癌術後1～3箇腋淋巴結暘性的T1 ～ T2期患者放療可以提高總的生存率及無病生存率,併且降低跼部區域的複髮率及遠處轉移率.
목적 평개유선암(개량)근치술후1～3개액림파결양성적T1～T2기환자방사치료적료효.방법 검색국내외상관수거고,이주제사화자유사상결합사열상관문헌.안조Cochrane 계통평개수책5.2질량평개표준,대납입문헌적방법학진행질량평개,용RevMan5.2연건진행Meta분석.결과 납입유선암(개량)근치술후1～3개액림파결양성적T1 ～ T2기환자,공14개연구,4 643례환자.기중,술후방료조2 080례,술후미방료조2 563례.여술후미방료조상비,술후방료조가이제고총생존솔(OR 1.89,95％ CI 1.55 ～2.31,P＜0.05)급무병생존솔(OR 2.16,95％CI1.80 ～2.60,P＜0.05),차강저료국부구역복발솔(OR0.22,95％ CI0.16 ～0.30,P＜0.05)급원처전이솔(OR0.57,95％ CI0.35 ～0.94,P＜0.05).이년령급종류적대소진행아조분석,＜40세화≥40세적환자국부구역복발솔차이유통계학의의(OR 0.15,95％CI0.05 ～0.48;OR0.33,95％ CI0.13 ～0.80,P＜0.05),술후방료대T1급T2환자균유익(OR 0.48,95％CI 0.24～0.96;OR 0.53,95％CI0.32 ～0.89,P＜0.05).결론 유선암술후1～3개액림파결양성적T1 ～ T2기환자방료가이제고총적생존솔급무병생존솔,병차강저국부구역적복발솔급원처전이솔.
Objective To comprehensively assess the effectiveness of post-mastectomy radiotherapy (PMRT) on the local control and survival of breast cancer patients with T1-T2 and 1-3 positive axillary lymph nodes using Meta-analysis.Methods Searching the documents of the domestic and foreign medical information databases with references to other papers to identify all clinical controlled trials on post-mastectomy radiotherapy versus without irradiation for postoperative breast cancer with T1-T2 and 1-3 positive lymph nodes.Quality assessment of these studies' methodology and date extraction were conducted according to the Cochrane Reviewer's handbook 5.2.Meta-analysis was performed using RevMan 5.2 software.Results There were 14 studies and 4 643 patients enrolled,including 2 080 cases in PMRT group and 2 563 in no-PMRT group.The Meta-analysis showed that there was a significant benefit for PMRT on overall survival rate (OR 1.89,95％ CI 1.55-2.31,P ＜ 0.05),disease-free survival (OR 2.16,95％ CI 1.80-2.60,P ＜ 0.05),while decreasing the risk of locoregional recurrence (OR 0.22,95％ CI0.16-0.30,P ＜0.05) and distant metastasis rate (OR 0.57,95％ CI 0.35-0.94,P ＜0.05).For further subset analysis,there are statistical significance between ages ＜ 40 and ≥ 40 (OR0.15,95％ CI0.05-0.48;OR 0.33,95％ CI 0.13-0.80,P ＜ 0.05),stages T1 and T2 (OR 0.48,95％ CI 0.24-0.96;OR 0.53,95％ CI 0.32-0.89,P ＜0.05) in breast cancer.Conclusions PMRT has benefit for overall survival rate,disease-free survival and significantly reduces the locoregional recurrence rate,distant metastasis rate in patients with T1-T2 tumors with 1-3 positive nodes.PMRT should be considered for patients with T1-T2 tumors with 1-3 positive nodes.
