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ORIGINAL ARTICLE
Year : 2016  |  Volume : 12  |  Issue : 1  |  Page : 84-89

Concurrent adjuvant radiochemotherapy versus standard chemotherapy followed by radiotherapy in operable breast cancer after breast conserving therapy: A meta-analysis


1 Department of Surgery, Ruijin Hospital, Medical School of Shanghai Jiaotong University, Shanghai, China
2 International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University, Shanghai, China

Correspondence Address:
Kunwei Shen
Department of Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University No.197 Ruijin Er, Huangpu District, Shanghai 200025
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.148702

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Background: To compare the efficacy of concurrent and sequential administration of radiotherapy and chemotherapy on patients with operable breast cancer after breast.conserving surgery. (BCS). Materials and Methods: We searched MEDLINE (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier, Amsterdam, Netherlands) databases for eligible studies. Clinical outcomes (such as overall and locoregional recurrence-free survival, toxicity related complications) used as evaluation indexes of efficacy. Odds ratios (ORs) with 95% confidence intervals (CI) of each index was calculated and analyzed with the RevMan Version 5.2 software. Results: Three articles (two trials), which compared the clinical efficacy of concurrent and sequential administration of radiotherapy and chemotherapy for operable breast cancer patients, were eligible in this meta-analysis. There were significant differences between concurrent and sequential treatments in 5-year loco-regional recurrence free survival (OR: 0.39, 95% CI: 0.20–0.75, P = 0.005) and late skin toxicity of telangiectasia (OR: 2.00, 95% CI: 1.39–2.87, P = 0.0002). However, no significant difference was discovered in five-year overall survival (OR: 0.62, 95% CI: 0.35–1.11, P > 0.05), acute skin toxicity (OR: 1.73, 95% CI: 0.98–3.04, P > 0.05) and late skin toxicity of lymphedema (OR: 1.27, 95% CI: 0.88–1.83, P > 0.05). Conclusion: Our study demonstrated that the concurrent administration of chemotherapy (anthracycline-based) and radiotherapy was superior to the sequential administration in locoregional recurrence-free survival for the operable node positive breast cancer patients. However, choose of treatment for operable breast cancer patients must be cautious due to high risk of lymphedema.


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