Partial-Breast Irradiation or Whole-Breast Radiotherapy for Early Breast Cancer: a Meta-Analysis of Randomized Trials

Polgár, Csaba; Strnad, Vratislav; Kovács, György

doi:10.1007/s00066-010-3001-9

Cited by 16 publications

(5 citation statements)

References 17 publications

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“…Clinically the emphasis has been made on developing fractionation schedules, immobilization procedures [21], and radiation techniques [14,25], e.g., 3D conformal therapy and intensitymodulated radiation therapy (IMRT), allowing the avoidance of 'hotspots' [5,12,23,39]. Despite these technical innovations, acute radiodermatitis still represents an important skin toxicity factor, as it may cause important loss of life quality and patient compliance [36] with a potential negative impact on RT treatment efficacy [6].…”

Section: Discussionmentioning

confidence: 99%

Topical Use of a Silymarin-Based Preparation to Prevent Radiodermatitis

Becker-Schiebe

Mengs²,

Schaefer³

et al. 2011

Strahlenther Onkol

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Section: Discussionmentioning

confidence: 99%

Topical Use of a Silymarin-Based Preparation to Prevent Radiodermatitis

Becker-Schiebe

Mengs²,

Schaefer³

et al. 2011

Strahlenther Onkol

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“…However, with innovation of several modalities, increasing number of multi-institute clinical trials, and altered schedules (APBI, IMRT, etc.) [1,5,9,16,18,19,26], an objective method to compare skin reactions by avoiding inter-observer and even intra-observer variations is needed. Thus, we have examined the possibility of utilizing a previously reported method by conducted longitudinal objective analysis after breast-conserving surgery [8].…”

Section: Discussionmentioning

confidence: 99%

Objective Assessment of Dermatitis Following Post-operative Radiotherapy in Patients with Breast Cancer Treated with Breast-conserving Treatment

et al. 2010

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“…Numerous meta-analyses and systematic reviews have been published on this subject since 2010 [105][106][107][108][109][110][111][112][113][114]. The number of included patients and follow-up time limited earlier analyses [105][106][107][108][109][110][111]. Newer publications either lack the inclusion of larger recently published trials [112] or excluded the three randomized trials performing PBI with IORT [114].…”

Section: Limitations Of Analysismentioning

confidence: 99%

Comparing Local and Systemic Control between Partial- and Whole-Breast Radiotherapy in Low-Risk Breast Cancer—A Meta-Analysis of Randomized Trials

Haussmann

Budach

Strnad

et al. 2021

Cancers

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Purpose/Objective: The standard treatment for localized low-risk breast cancer is breast-conserving surgery, followed by adjuvant radiotherapy and appropriate systemic therapy. As the majority of local recurrences occur at the site of the primary tumor, numerous trials have investigated partial-breast irradiation (PBI) instead of whole-breast treatment (WBI) using a multitude of irradiation techniques and fractionation regimens. This meta-analysis addresses the impact on disease-specific endpoints, such as local and regional control, as well as disease-free survival of PBI compared to that of WBI in published randomized trials. Material and Methods: We conducted a systematic literature review and searched for randomized trials comparing WBI and PBI in early-stage breast cancer with publication dates after 2009. The meta-analysis was based on the published event rates and the effect sizes for available oncological endpoints of at least two trials reporting on them. We evaluated in-breast tumor recurrences (IBTR), local recurrences at the primary site and elsewhere in the ipsilateral breast, regional recurrences (RR), distant metastasis-free interval (DMFI), disease-free survival (DFS), contralateral breast cancer (CBC), and second primary cancer (SPC). Furthermore, we aimed to assess the impact of different PBI techniques and subgroups on IBTR. We performed all statistical analyses using the inverse variance heterogeneity model to pool effect sizes. Results: For the intended meta-analysis, we identified 13 trials (overall 15,561 patients) randomizing between PBI and WBI. IBTR was significantly higher after PBI (OR = 1.66; CI-95%: 1.07–2.58; p = 0.024) with an absolute difference of 1.35%. We detected significant heterogeneity in the analysis of the PBI technique with intraoperative radiotherapy resulting in higher local relapse rates (OR = 3.67; CI-95%: 2.28–5.90; p < 0.001). Other PBI techniques did not show differences to WBI in IBTR. Both strategies were equally effective at the primary tumor site, but PBI resulted in statistically more IBTRs elsewhere in the ipsilateral breast. IBTRs after WBI were more likely to be located at the primary tumor bed, whereas they appeared equally distributed within the breast after PBI. RR was also more frequent after PBI (OR = 1.75; CI-95%: 1.07–2.88; p < 0.001), yet we did not detect any differences in DMFI (OR = 1.08; CI-95%: 0.89–1.30; p = 0.475). DFS was significantly longer in patients treated with WBI (OR = 1.14; CI-95%: 1.02–1.27; p = 0.003). CBC and SPC were not different in the test groups (OR = 0.81; CI-95%: 0.65–1.01; p = 0.067 and OR = 1.09; CI-95%: 0.85–1.40; p = 0.481, respectively). Conclusion: Limiting the target volume to partial-breast radiotherapy appears to be appropriate when selecting patients with a low risk for local and regional recurrences and using a suitable technique.

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Partial-Breast Irradiation or Whole-Breast Radiotherapy for Early Breast Cancer: a Meta-Analysis of Randomized Trials

Cited by 16 publications

References 17 publications

Topical Use of a Silymarin-Based Preparation to Prevent Radiodermatitis

Topical Use of a Silymarin-Based Preparation to Prevent Radiodermatitis

Objective Assessment of Dermatitis Following Post-operative Radiotherapy in Patients with Breast Cancer Treated with Breast-conserving Treatment

Comparing Local and Systemic Control between Partial- and Whole-Breast Radiotherapy in Low-Risk Breast Cancer—A Meta-Analysis of Randomized Trials

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