乳腺癌保乳术后常规切线野放疗与调强放疗剂量学比较的Meta分析

doi:10.11904/j.issn.1002-3070.2016.01.003

Abstract

Abstract: Objective To evaluate the advantage and disadvantage of IMRT,we established this Meta-analysis which gives service to clinical therapy.Methods Clinical researches of dosimetric comparisons between CRT and IMRT for conservative-breast therapy were obtained from the Pubmed,Science,EMbase,CNKI(Zhong Guo Zhi Wang)and Wan Fang databases up to April 2015.The data calculated and analyzed using the StataSE 12.0 software.Results Twelve researches were included.Comparing to CRT,IMRT significantly decreased the homogeneity index(HI)(SMD=1.102,95%CI:0.699~1.504,P＜0.001).IMRT significantly lowered the lung V20,lung V30,heart V30 and heart V40,whileas the lung V5,lung V10 and heart V5 were not lowered.Conclusion Comparing to CRT,IMRT achieves better homogeneity of dose distribution and reduces irradiated volumes of heart and lung in high-dose areas without decreases irradiated volumes in low-dose areas,which provides evidence to choose valuable clinical technique.

Key words: Breast cancer, Conservative surgery, Radiotherapy, Dosimetric comparison, Meta-analysis

CLC Number:

R737.9

SUN Yan, CUI Qinling, ZHONG Wen, GUO Genyan, ZHAO Jiaying, JIANG Shiwen, CHEN Yanzhi, ZHAO Yuxia. Dosimetric comparisons of conventional tangential radiotherapy and intensity modulated radiotherapy in conservative-breast therapy:A Meta-analysis[J]. PRACTICAL ONCOLOGY JOURNAL, 2016, 30(1): 11-16.

References

1 Darby S,McGale P,Correa C,et al.Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death:meta-analysis of individual patient data for 10,801 women in 17 randomized trials[J].Lancet,2011,378(9804):1707-1716.
2 Buchholz TA,Gurgoze E,Bice WS,et al.Dosimetric analysis of intact breast irradiation in off－axis planes[J].Int J Radiat Oncol Biol Phys,1997,39(1):261-267.
3 Andrew F,Regina B,Mardi B,et al.Dosimetric comparison of intensity modulated radiotherapy techniques and standard wedged tangents for whole breast radiotherapy[J].J Med Imaging Radiat Oncol,2009,53(1):92-99.
4 Hardee ME,Raza S,Becker SJ,et al.Prone hypofractionated whole-breast radiotherapy without a boost to the tumor bed:comparable toxicity of IMRT versus a 3D conformal technique[J].Int J Radiat Oncol Biol Phys,2012,82(3):415-423.
5 Mansouri S,Naim A,Glaria L,et al.Dosimetric evaluation of 3-D conformal and intensitymodulated radiotherapy for breast cancer after conservative surgery[J].Asian Pac J Cancer Prev,2014,15(11):4727-4732.
6 Xie X,Ouyang S,Wang H,et al.Dosimetric comparison of left-sided whole breast irradiation with 3D-CRT,IP-IMRT and hybrid IMRT[J].Oncol Rep,2014,31(5):2195-2205.
7 Ahmed RS,De Los Santos JF,Fiveash JB,et al.An IMRT technique to increase therapeutic ratio of breast irradiation in patients with early-stage left breast cancer:limiting second　maligancies[J].Med Dosim,2008,33(1):71-77.
8 Lin Y,Wang B.Dosimetric absorption of intensity modulated radiotherapy compared with conventional radiotherapy in breast-conserving surgery[J].Oncol Lett,2015,9(1):9-14.
9 Early Breast Cancer Trialists′ Collaborative Group.Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer:an overview of the randomised trials[J].Lancet,2000,355(9217):1757-1770.
10 Moody AM,Mayles WP,Bliss JM,et a1.The influence of breast size on late radiation effects and association with radiotherapy dose inhomogeneity[J].Radiother Oncol,1994,33(2):106-112.
11 Whitton A,Warde P,Sharpe M,et al.Organisational standards for the delivery of intensity-modulated radiation therapy in Ontario[J].Clin Oncol(R Coll Radiol),2009,21(3):192-203.
12 Taylor ME,Perez CA,Halverson KJ,et a1.Factors influencing cosmetic results after conservation therapy for breast cancer[J].Int J Radiat Oncol Biol Phys,1995,31(4):753-764.
13 Gokula K,Earnest A,Wong LC.Meta-analysis of incidence of early lung toxicity in 3-dimensional conformal irradiation of breast carcinomas[J].Radiat Oncol,2013,8(1):268-279.
14 Michael SL,Will F,Ehtisham M.Cardiovascular complications of radiotherapy[J].Am J Cardiol,2013,112(10):1688-1696.
15 Grantzau T,Overqaard J.Risk of second non-breast cancer after radiotherapy for breast cancer:A systematic review and meta-analysis of 762,468 patients[J].Radiother Oncol,2015,114(1):56-65.
16 Smith BD,Pan IW,Shih YC,et al.Adoption of intensity modulated radiation therapy for breast cancer in the United States[J].J Natl Cancer Inst,2011,103(10):798-809.
17 Zhang F,Zheng M.Dosimetric evaluation of conventional radiotherapy,3-D conformal radiotherapy and direct machine parameter optimisation intensity-modulated radiotherapy for breast cancer after conservative surgery[J].J Med Imaging Radiat Oncol,2011,55(6):595-602.
18 黄晓波,蒋国探,陈佳艺,等.乳腺癌调强放射治疗和常规切线野治疗的三维剂量学研究[J].癌症,2006,25(7):855-860.
19 Gursel B,Meydan D,Ozbek N,et al.Dosimetric comparison of three different external beam whole breast irradiation techniques[J].Adv Ther,2011,28(12):1114-1125.
20 Onal C,Sonmez A,Arslan G,et al.Dosimetric comparison of the field-in-field technique and tangential wedged beams for breast irradiation[J].Jpn J Radiol,2012,30(3):218-226.
21 Badakhshi H,Kaul D,Nadobny J,et al.Image-guided volumetric modulated arc therapy for breast cancer:a feasibility study and plan comparison with three-dimensional conformal and intensity-modulated radiotherapy[J].Br J Radiol,2013,86(1032):20130515.
22 田磊,李辉成,池琦,等.乳腺癌保乳术后动态调强放疗与常规放疗的剂量学比较[J].中国辐射卫生,2014,23(1):57-59.
23 Ercan T,Iqdem S,Alco G,et al.Dosimetric comparison of field in field intensity-modulated radiotherapy technique with conformal radiotherapy techniques in breast cancer[J].Jpn J Radiol,2010,28(4):283-289.
24 王嘉伟,张树平.乳腺癌保乳术后调强放疗与常规放疗的剂量学比较[J].肿瘤与临床,2010,22(3):182-185.
25 艾秀清,木妮热·木沙江,朱相露,等.左侧乳腺癌保乳术后调强放疗的剂量学研究[J].实用癌症杂志,2014,29(8):984-986.
26 Baycan D,Karacetin D,Balkanay AY,et al.Field-in-field IMRT versus 3D-CRT of the　breast.Cardiac vessels,ipsilateral lung,and contralateral breast absorbed doses in patients with left-sided lumpectomy:a dosimetric comparison[J].Jpn J Radiol,2012,30(10):819-823.

[1]	WANG Xiaoya,XIAO Bin,LIAO Yang,TANG Rongzhi,SUN Zhaohui,LI Linhai. Expression of CXCR family proteins in different subtypes of breast cancer and their clinical prognosis [J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(3): 206-210.
[2]	LI Shuo,ZHANG Nannan,LI Liangliang,LONG Zhiping,YIN Huihui,ZHAO Yashuang,WANG Fan. Relationship between PDE4C gene methylation in peripheral blood leukocytes,interaction of environmental factors and pathogenesis of breast cancer [J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(3): 233-238.
[3]	LI Jiaqi,LUAN Jinwei,ZHANG Yu,LI Xianglan. Analysis of clinicopathological features,recurrence and metastasis in 763 triple-negative breast cancer [J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(3): 244-249.
[4]	LI Shan,ZHAO Chunbo,QIAO Wenbo. Progress in the application of intraoperative radiotherapy in pancreatic cancer [J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(3): 280-283.
[5]	FENG Yue,XING Linan,WANG Zhao,ZHANG Yunyan. Correlation between NLR and prognosis of concurrent chemoradiotherapy [J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(3): 284-288.
[6]	CHEN Yanbo, KONG Dejia, ZHANG Jinfeng, MA Zhigang. Correlation between CYP2D6 gene polymorphism and tamoxifen metabolism in breast cancer patients [J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(2): 110-114.
[7]	SUN Jianghong, HAO Mingzhu, JIANG Dan, GUO Fei, LI Xiaomei. FFDM differential diagnosis of mastitis,benign hyperplasia and breast cancer [J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(2): 139-141.
[8]	MA Zhijie, WANG Fan, ZHAO Yashuang. Analysis of life quality and influencing factors in breast cancer patients with chemotherapy [J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(2): 149-154.
[9]	MA Zhingying, SHANG Naijian, CAI Miaotian, SHEN Yang, JIANG Zhiyun. Correlation between HER-2 receptor of progesterone and estrogen receptor-positive breast cancer and mammography imaging & clinicopathological features [J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(1): 47-51.
[10]	ZHANG Pan, ZHANG Di, DAI Xiaobo. Advanced in re-radiotherapy for recurrent nasopharyngeal carcinoma [J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(1): 92-96.
[11]	WANG Yalong, LYU Zhangyan, ZHANG Fan, FENG Xiaoshuang, WEI Luopei, LI Xin, WEN Yan, GAO Yushun, XUE Qi, GAO Shugeng, TAN Fengwei. Relationship between human papillomavirus infection and prognosis of lung cancer:A meta-analysis [J]. PRACTICAL ONCOLOGY JOURNAL, 2018, 32(6): 520-526.
[12]	HE Xu, YE shangmian, DONG dandan, LI Ke. The expression of HLA-G in breast cancer and its significance [J]. PRACTICAL ONCOLOGY JOURNAL, 2018, 32(5): 410-414.
[13]	LIN Rongjie, YIN Hang, ZHOU Yunfeng. Effect of ON123300 on ER+ human breast cancer MCF-7 cells and its mechanism [J]. PRACTICAL ONCOLOGY JOURNAL, 2018, 32(3): 193-197.
[14]	LI Lin, LI Zhigao. The relationship between metformin and different molecular subtypes of breast cancer [J]. PRACTICAL ONCOLOGY JOURNAL, 2018, 32(3): 267-270.
[15]	DU Yesheng, HU Songliu, XU Xiangying. Study of oligodendrocyte metastasis in non-small cell lung cancer by stereotactic radiotherapy [J]. PRACTICAL ONCOLOGY JOURNAL, 2018, 32(2): 154-158.

Dosimetric comparisons of conventional tangential radiotherapy and intensity modulated radiotherapy in conservative-breast therapy:A Meta-analysis

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments