Gustavo Nader Marta1, Cristiane Rufino Macedo2, Heloisa de Andrade Carvalho3, Samir Abdallah Hanna4, João Luis Fernandes da Silva5, Rachel Riera6. 1. Department of Radiation Oncology, Hospital Sírio-Libanês, Brazil; Department of Radiation Oncology, Instituto do Câncer de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, Brazil. Electronic address: gnmarta@uol.com.br. 2. Brazilian Cochrane Center and Discipline of Emergency Medicine and Evidence-Based Medicine, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP-EPM), Brazil. Electronic address: crisrufa@terra.com.br. 3. Department of Radiation Oncology, Hospital Sírio-Libanês, Brazil; Department of Radiation Oncology, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. Electronic address: heloisa.carvalho@hc.fm.usp.br. 4. Department of Radiation Oncology, Hospital Sírio-Libanês, Brazil. Electronic address: samir.hanna@hsl.org.br. 5. Department of Radiation Oncology, Hospital Sírio-Libanês, Brazil. Electronic address: jluis@hsl.org.br. 6. Brazilian Cochrane Center and Discipline of Emergency Medicine and Evidence-Based Medicine, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP-EPM), Brazil. Electronic address: rachelriera@hotmail.com.
Abstract
BACKGROUND AND PURPOSE: Accelerated partial breast irradiation (APBI) is the strategy that allows adjuvant treatment delivery in a shorter period of time in smaller volumes. This study was undertaken to assess the effectiveness and outcomes of APBI in breast cancer compared with whole-breast irradiation (WBI). MATERIAL AND METHODS: Systematic review and meta-analysis of randomized controlled trials of WBI versus APBI. Two authors independently selected and assessed the studies regarding eligibility criteria. RESULTS: Eight studies were selected. A total of 8653 patients were randomly assigned for WBI versus APBI. Six studies reported local recurrence outcomes. Two studies were matched in 5 years and only one study for different time of follow-up. Meta-analysis of two trials assessing 1407 participants showed significant difference in the WBI versus APBI group regarding the 5-year local recurrence rate (HR=4.54, 95% CI: 1.78-11.61, p=0.002). Significant difference in favor of WBI for different follow-up times was also found. No differences in nodal recurrence, systemic recurrence, overall survival and mortality rates were observed. CONCLUSIONS: APBI is associated with higher local recurrence compared to WBI without compromising other clinical outcomes.
BACKGROUND AND PURPOSE: Accelerated partial breast irradiation (APBI) is the strategy that allows adjuvant treatment delivery in a shorter period of time in smaller volumes. This study was undertaken to assess the effectiveness and outcomes of APBI in breast cancer compared with whole-breast irradiation (WBI). MATERIAL AND METHODS: Systematic review and meta-analysis of randomized controlled trials of WBI versus APBI. Two authors independently selected and assessed the studies regarding eligibility criteria. RESULTS: Eight studies were selected. A total of 8653 patients were randomly assigned for WBI versus APBI. Six studies reported local recurrence outcomes. Two studies were matched in 5 years and only one study for different time of follow-up. Meta-analysis of two trials assessing 1407 participants showed significant difference in the WBI versus APBI group regarding the 5-year local recurrence rate (HR=4.54, 95% CI: 1.78-11.61, p=0.002). Significant difference in favor of WBI for different follow-up times was also found. No differences in nodal recurrence, systemic recurrence, overall survival and mortality rates were observed. CONCLUSIONS:APBI is associated with higher local recurrence compared to WBI without compromising other clinical outcomes.
Authors: Krishan R Jethwa; Sean S Park; Karthik Gonuguntla; Stephanie M Wick; Laura A Vallow; Christopher L Deufel; Thomas J Whitaker; Keith M Furutani; Kathryn J Ruddy; Kimberly S Corbin; Tina J Hieken; Robert W Mutter Journal: Int J Radiat Oncol Biol Phys Date: 2018-12-21 Impact factor: 7.038
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Authors: S Garduño-Sánchez; I Villanego-Beltrán; M Dolores de Las Peñas-Cabrera; J Jaén-Olasolo Journal: Clin Transl Oncol Date: 2021-07-02 Impact factor: 3.405