BACKGROUND: To compare the efficacy of concurrent and sequential administration of radiotherapy and chemotherapy on patients with operable breast cancer after breast.conserving surgery. (BCS). MATERIALS AND METHODS: We searched MEDLINE (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier, Amsterdam, Netherlands) databases for eligible studies. Clinical outcomes (such as overall and locoregional recurrence-free survival, toxicity related complications) used as evaluation indexes of efficacy. Odds ratios (ORs) with 95% confidence intervals (CI) of each index was calculated and analyzed with the RevMan Version 5.2 software. RESULTS: Three articles (two trials), which compared the clinical efficacy of concurrent and sequential administration of radiotherapy and chemotherapy for operable breast cancer patients, were eligible in this meta-analysis. There were significant differences between concurrent and sequential treatments in 5-year loco-regional recurrence free survival (OR: 0.39, 95% CI: 0.20-0.75, P = 0.005) and late skin toxicity of telangiectasia (OR: 2.00, 95% CI: 1.39-2.87, P = 0.0002). However, no significant difference was discovered in five-year overall survival (OR: 0.62, 95% CI: 0.35-1.11, P > 0.05), acute skin toxicity (OR: 1.73, 95% CI: 0.98-3.04, P > 0.05) and late skin toxicity of lymphedema (OR: 1.27, 95% CI: 0.88-1.83, P > 0.05). CONCLUSION: Our study demonstrated that the concurrent administration of chemotherapy (anthracycline-based) and radiotherapy was superior to the sequential administration in locoregional recurrence-free survival for the operable node positive breast cancer patients. However, choose of treatment for operable breast cancer patients must be cautious due to high risk of lymphedema.
BACKGROUND: To compare the efficacy of concurrent and sequential administration of radiotherapy and chemotherapy on patients with operable breast cancer after breast.conserving surgery. (BCS). MATERIALS AND METHODS: We searched MEDLINE (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier, Amsterdam, Netherlands) databases for eligible studies. Clinical outcomes (such as overall and locoregional recurrence-free survival, toxicity related complications) used as evaluation indexes of efficacy. Odds ratios (ORs) with 95% confidence intervals (CI) of each index was calculated and analyzed with the RevMan Version 5.2 software. RESULTS: Three articles (two trials), which compared the clinical efficacy of concurrent and sequential administration of radiotherapy and chemotherapy for operable breast cancerpatients, were eligible in this meta-analysis. There were significant differences between concurrent and sequential treatments in 5-year loco-regional recurrence free survival (OR: 0.39, 95% CI: 0.20-0.75, P = 0.005) and late skin toxicity of telangiectasia (OR: 2.00, 95% CI: 1.39-2.87, P = 0.0002). However, no significant difference was discovered in five-year overall survival (OR: 0.62, 95% CI: 0.35-1.11, P > 0.05), acute skin toxicity (OR: 1.73, 95% CI: 0.98-3.04, P > 0.05) and late skin toxicity of lymphedema (OR: 1.27, 95% CI: 0.88-1.83, P > 0.05). CONCLUSION: Our study demonstrated that the concurrent administration of chemotherapy (anthracycline-based) and radiotherapy was superior to the sequential administration in locoregional recurrence-free survival for the operable node positive breast cancerpatients. However, choose of treatment for operable breast cancerpatients must be cautious due to high risk of lymphedema.
Authors: Jianqing Lin; Robert B Den; Jacob Greenspan; Timothy N Showalter; Jean H Hoffman-Censits; Costas D Lallas; Edouard J Trabulsi; Leonard G Gomella; Mark D Hurwitz; Benjamin Leiby; Adam P Dicker; W Kevin Kelly Journal: Int J Radiat Oncol Biol Phys Date: 2020-02-03 Impact factor: 7.038