本文選題：早期乳腺癌 + 大分割放療��； 參考：《廣西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：背景與目的：術(shù)后放療是早期乳腺癌的標(biāo)準(zhǔn)治療方式之一。然而,放射治療的最佳分割模式還存在許多的爭(zhēng)議,我們寫該meta分析的目的是相互對(duì)比大分割放療(HRT)和常規(guī)分割放療(CRT)在術(shù)后早期乳腺癌患者中的療效。因此,我們?cè)陔S機(jī)對(duì)照試驗(yàn)的基礎(chǔ)上進(jìn)行了該meta分析,評(píng)價(jià)常規(guī)分割放療和大分割放療對(duì)于術(shù)后早期乳腺癌患者的作用。方法：由兩位獨(dú)立的作者全面地檢索Pubmed、Cochrane Central Trials Registry, Medline, Web of Science和相關(guān)期刊論文。納入文獻(xiàn)限制在早期乳腺癌患者的隨機(jī)對(duì)照實(shí)驗(yàn)中,主要的觀察指標(biāo)為：總體生存率(OS)、3-5年和10年的局部復(fù)發(fā)率(LR)、遠(yuǎn)處復(fù)發(fā)率(DR)和乳房外形變化。本Meta分析運(yùn)用的是Review manager5.0版本,并且使用OR相對(duì)應(yīng)的95%的可信區(qū)間(CI)來(lái)代表結(jié)果。結(jié)果：本meta分析納入5項(xiàng)隨機(jī)對(duì)照研究總共8009例早期乳腺癌患者。經(jīng)分析顯示與常規(guī)分割放療對(duì)比,大分割放療在3-5年局部復(fù)發(fā)率(OR=0.98,95% CI區(qū)間：0.79-1.20,P=0.82)、10年局部復(fù)發(fā)率(OR=0.96,95% CI區(qū)間：0.81-1.14,P=0.65)、遠(yuǎn)處復(fù)發(fā)(OR= 1.10,95% CI區(qū)間：0.75-1.62,P=0.61)、總體生存率(OR=1.08,95% CI:區(qū)間0.93-1.26,P=0.32)方面幾乎相似,無(wú)統(tǒng)計(jì)學(xué)意義。在保乳術(shù)后乳房外形變化的亞組分析中顯示,分次劑量3.3Gy的大分割放療組無(wú)統(tǒng)計(jì)學(xué)差異(OR=1.05,95% CI：0.74-1.49,P=0.79),然而,分次劑量"g3.3Gy的大分割放療組(OR=1.48,95% CI:1.09-2.01, P= 0.01),差異有統(tǒng)計(jì)學(xué)意義,說(shuō)明分次劑量"g3.3Gy的大分割放療組增加保乳術(shù)后早期乳腺癌患者乳房外形的變化。結(jié)論：該研究是關(guān)于術(shù)后早期乳腺癌患者使用大分割放射治療的安全性和有效性的meta分析。通過(guò)本研究表明分次劑量"g3.3Gy的大分割放療組在保乳術(shù)后早期乳腺癌患者中增加了乳房外形的變化,然而在總體生存率、遠(yuǎn)處復(fù)發(fā)、3～5年和10年局部復(fù)發(fā)率沒(méi)有差別。
[Abstract]:Background and purpose: postoperative radiotherapy is one of the standard treatments for early breast cancer. However, there are many controversies in the best segmentation mode of radiotherapy. The purpose of this meta analysis is to compare the efficacy of large fractionation radiotherapy (HRT) and conventional fractionated radiotherapy (CRT) in the early postoperative breast cancer patients. Therefore, we are at random The meta analysis was conducted on the basis of the controlled trial to evaluate the role of conventional fractionated radiotherapy and large fractionated radiotherapy for early postoperative breast cancer patients. Methods: two independent authors were fully retrieved Pubmed, Cochrane Central Trials Registry, Medline, Web of Science, and the full text database of Chinese periodicals. In the randomized controlled trial of patients with breast cancer, the main indicators were the overall survival rate (OS), the local recurrence rate (LR) in 3-5 and 10 years, the distant recurrence rate (DR) and the change of the breast shape. The Meta analysis used the Review manager5.0 version, and the 95% confidence interval (CI) corresponding to the OR phase was used to represent the results. A total of 8009 patients with early breast cancer were analyzed in 5 randomized controlled studies. Compared with conventional fractionation radiotherapy, the local recurrence rate (OR=0.98,95% CI interval: 0.79-1.20, P=0.82), 10 year local recurrence rate (OR=0.96,95% CI interval: 0.81-1.14, P=0.65), and distant recurrence (OR= 1.10,95% CI interval: 0.75-1.) were compared with conventional fractionated radiotherapy. 62, P=0.61), the overall survival rate (OR=1.08,95% CI: interval 0.93-1.26, P=0.32) was almost similar, without statistical significance. In subgroup analysis of breast shape changes after breast conserving surgery, there was no statistical difference in the fractionated dose 3.3Gy large fractionated radiotherapy group (OR=1.05,95% CI: 0.74-1.49, P=0.79), however, the fractionated dose "g3.3Gy large fractionation radiotherapy" Group (OR=1.48,95% CI:1.09-2.01, P= 0.01), the difference was statistically significant, indicating that the fractionated dose of "g3.3Gy" in large fractionation radiotherapy group increased breast shape changes in early breast cancer patients after breast conserving surgery. Conclusion: This study is a meta analysis of the safety and effectiveness of early postoperative breast cancer patients using large segmented radiotherapy. The study showed that the fractionated dose of "g3.3Gy 'large fractionated radiotherapy group increased breast shape changes in early breast cancer patients after breast conserving surgery, but there was no difference in the overall survival rate, distant recurrence, and 3~5 and 10 year local recurrence rates.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R737.9

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本文編號(hào)：1953776