Abstract
ObjectiveThis meta-analysis evaluated the efficacy and safety of accelerated partial breast irradiation versus whole-breast irradiation for early-stage breast cancer after breast-conserving surgery.Materials and methodsA systematic search of PubMed, Embase, and the Cochrane libraries was performed according to the PRISMA statement the last 10 years to April 7, 2020 to identify the randomized controlled trials of APBI versus WBI for treating patients with early-stage breast cancer. Two independent observers evaluated the identified studies. The obtained data were analyzed using the RevMan 5.3 software.ResultsA total of 10 randomized controlled trials involving 15,500 patients with early-stage breast cancer were selected according to the inclusion and exclusion criteria and included in this meta-analysis. In this meta-analysis, we included ten studies that reported local recurrence and found significant differences in local recurrence rates (HR = 1.46; 95% CI 1.20–1.79, P = 0.0002). Further analysis showed that this difference may be related to the choice of treatment methods. No differences in distant metastasis, breast cancer deaths, contralateral breast cancer, disease-free survival, and overall survival rates were observed between WBI and APBI groups. There was no significant difference in late toxicity, cosmetic outcomes and quality of life between the two groups, the compliance and tolerance of the patients were well. Compared to whole breast irradiation, accelerated partial breast irradiation significantly reduced serious (≥ grade 2) early toxicities, especially regarding acute skin toxicity.ConclusionsThe analysis showed that patients receiving APBI had a higher local recurrence rate, but no differences in distant metastasis, breast cancer deaths, contralateral breast cancer, disease-free survival, and overall survival rates.
Highlights
Breast cancer was the most frequently diagnosed cancer and the most frequent cause of death from cancer in women [1]
The analysis showed that patients receiving Accelerated partial breast irradiation (APBI) had a higher local recurrence rate, but no differences in distant metastasis, breast cancer deaths, contralateral breast cancer, disease-free survival, and overall survival rates
Selection criteria The eligibility criteria of the study are as follows: (1) Patients diagnosed with early-stage breast cancer; (2) Two comparison groups, one group receiving accelerated partial breast radiotherapy and the other group receiving whole breast radiotherapy; (3) At least local recurrence rate data are reported or reported other outcomes; (4) Randomized controlled trials (RCTs); (5) Language restrictions in English; (6) the sample size of the study was more than 50 cases
Summary
Breast cancer was the most frequently diagnosed cancer and the most frequent cause of death from cancer in women [1]. Breast-conserving surgery combined with whole-breast irradiation (WBI) has been the gold standard therapy for patients with early-stage breast cancer, which can yield cancer outcomes comparable to mastectomy [2, 3]. Xiang et al Radiat Oncol (2021) 16:24 radiotherapy problematic for women with some socioeconomic barriers [4,5,6]. Accelerated partial breast irradiation (APBI) only irradiates the tumor bed in one week or less, which is a very favorable treatment that can reduce the burden of care and make it more likely to be accepted by patients [9]. Due to the smaller irradiation range of APBI, it is expected to reduce toxicity and improve cosmetic effect and quality of life compared with whole-breast irradiation [10]
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