目的:荟萃文献,对比分析前哨淋巴结微转移早期乳腺癌患者全乳切除术后行与未行放射治疗的预后.方法:检索中国生物医学文献数据库(China Biology Medicine,CBM)、中国期刊全文数据库(China Na-tional Knowledge Infrastructure,CNKI)、维普(VIP)、万方数据库、PubMed数据库、Embase数据库、Web of sci-ence(WOS)数据库、Cochrane数据库,由2 名研究者各自独立对入选研究的有关试验设计、研究对象特征、研究结果等进行摘录,采用纽卡斯尔渥太华量表进行质量评价,采用Stata 17.0 及Review Manager 5.4 进行Me-ta分析.结果:最终筛选出9 篇相关文献,均为回顾性研究.中位随访 30~98 个月.术后放射治疗组与非放射治疗组乳腺癌特异性生存期(breast cancer-specific survival,BCSS)差异无统计学意义(HR =1.18,95%CI:0.94~1.48,Z =1.43,P =0.15);两组无病生存期(disease-free survival,DFS)差异亦无统计学意义(HR = 0.51,95%CI:0.07~3.62,Z =-0.668,P =0.50);两组总生存期(overall survival,OS)差异亦无统计学意义(HR =1.02,95%CI:0.93~1.12,Z =0.39,P =0.70).结论:前哨淋巴结微转移早期乳腺癌患者(T0、T1~2NmiM0)全乳切除术后予以放射治疗并不能改善患者的BCSS、DFS、OS.
Objective:To compare and analyze the prognosis of patients with early stage breast cancer with micro-metastases in the sentinel lymph nodes treated with post-mastectomy radiation therapy(PMRT)after mastectomy and without PMRT.Methods:China Biology Medicine(CBM),China National Knowledge Infrastructure(CNKI),Chi-na Science and Technology Journal Database,Wanfang database,PubMed database,Embase database,Web of sci-ence(WOS)database,and Cochrane library.The screening was independently performed by two researchers ac-cording to the inclusion and exclusion criteria,extracting data,assessing methodological quality,and analyzing re-sults were achieved.Stata17.0 and Review Manager5.4 software were applied for Meta-analysis.Results:A total of nine retrospective studies were included,with a median follow-up of 30 to 98 months.Meta-analysis showed that the PMRT after mastectomy did not significantly improve the breast cancer-specific survival(BCSS)(HR =1.18,95%CI:0.94-1.48,Z =1.43,P =0.15),disease-free survival(DFS)(HR =0.51,95%CI:0.07-3.62,Z =-0.668,P =0.50),and overall survival(OS)(HR =1.02,95%CI:0.93-1.12,Z =0.39,P =0.70)in the early-stage breast cancer with sentinel lymph node micro-metastasis.Conclusion:For patients with early-stage breast cancer and micro-metastases in the sentinel lymph nodes(T0,T1-2NmiM0),PMRT after mastectomy does not improve BCSS,DFS,and OS.