Systematic review and meta-analysis comparing hypofractionated with conventional fraction radiotherapy in treatment of early breast cancer. (September 2015)

• Record Type: Journal Article
• Authors: Zhou, Zhi-Rui; Mei, Xin; Chen, Xing-Xing; Yang, Zhao-Zhi; Hou, Jing; Zhang, Li; Yu, Xiao-Li; Guo, Xiao-Mao
• Is Part Of: Surgical oncology. Volume 24:Number 3(2015)
• Page Start: 200
• Page End: 211
• Publication Date: 2015-09
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2015.06.005
• Languages: English
• ISSNs: 0960-7404

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Background</title> <p id="abspara0010">The purpose of this meta-analysis is to evaluate the efficacy and safety of altered radiation fraction size on outcomes for early breast cancer patients.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">A search of MEDLINE, EMBASE, WEB OF SCIENCE, Cochrane Library and <ext-link ext-link-type="unknown" id="intref0010" xlink:type="simple" xlink:href="http://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link> was conducted. Quality of the randomized controlled trials (RCTs) or non-RCTs were evaluated according to Cochrane's risk of bias tool or Methodological Index for non-Randomized Studies (MINORS). Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated. Subgroup analysis was applied according to different fraction dose and sensitivity analysis was performed according to RCTs or non-RCTs.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">23 studies were included in this systematic review. Meta-analysis demonstrated hypofractionation radiotherapy (HFRT) was associated with decreased grade 2/3 acute skin reactions compared with conventional fraction RT (CFRT), either 2.5–3.0 Gy per fraction or 5.0–6.5 Gy per fraction. HFRT with 2.5–3.0 Gy per fraction significantly decreased moderate/marked photographic changes in breast appearance compared with CFRT [RR = 0.80, 95% CI (0.70, 0.91), <italic>P</italic> = 0.001], while HFRT with more than 3.0 Gy per fraction significantly increased moderate/marked photographic changes [RR = 1.21, 95% CI (1.06, 1.38), <italic>P</italic> = 0.004]. In addition HFRT cost one-third lower than CFRT. Regarding to local regional recurrence, distant metastasis, overall survival, disease free survival, excellent/good cosmetic comes, symptomatic radiation pneumonitis, ischemic heart disease and symptomatic rib fracture, there was no significant difference between two arms.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">Based on available evidence, HFRT with 2.5–3.0 Gy per fraction should be the better choice for treatment of early breast cancer patients.</p> </sec> </abstract>