PMID- 37289549
OWN - NLM
STAT- MEDLINE
DCOM- 20230908
LR  - 20230929
IS  - 1460-2105 (Electronic)
IS  - 0027-8874 (Print)
IS  - 0027-8874 (Linking)
VI  - 115
IP  - 9
DP  - 2023 Sep 7
TI  - Partial breast irradiation compared with whole breast irradiation: a systematic 
      review and meta-analysis.
PG  - 1011-1019
LID - 10.1093/jnci/djad100 [doi]
AB  - BACKGROUND: Early-stage breast cancer is among the most common cancer diagnoses. 
      Adjuvant radiotherapy is an essential component of breast-conserving therapy, and 
      several options exist for tailoring its extent and duration. This study assesses 
      the comparative effectiveness of partial-breast irradiation (PBI) compared with 
      whole-breast irradiation (WBI). METHODS: A systematic review was completed to 
      identify relevant randomized clinical trials and comparative observational 
      studies. Independent reviewers working in pairs selected studies and extracted 
      data. Randomized trial results were pooled using a random effects model. 
      Prespecified main outcomes were ipsilateral breast recurrence (IBR), cosmesis, 
      and adverse events (AEs). RESULTS: Fourteen randomized clinical trials and 6 
      comparative observational studies with 17 234 patients evaluated the comparative 
      effectiveness of PBI. PBI was not statistically significantly different from WBI 
      for IBR at 5 years (RR = 1.34, 95% CI = 0.83 to 2.18; high strength of evidence 
      [SOE]) and 10 years (RR = 1.29, 95% CI = 0.87 to 1.91; high SOE). Evidence for 
      cosmetic outcomes was insufficient. Statistically significantly fewer acute AEs 
      were reported with PBI compared with WBI, with no statistically significant 
      difference in late AEs. Data from subgroups according to patient, tumor, and 
      treatment characteristics were insufficient. Intraoperative radiotherapy was 
      associated with higher IBR at 5, 10, and over than 10 years (high SOE) compared 
      with WBI. CONCLUSIONS: Ipsilateral breast recurrence was not statistically 
      significantly different between PBI and WBI. Acute AEs were less frequent with 
      PBI. This evidence supports the effectiveness of PBI among selected patients with 
      early-stage, favorable-risk breast cancer who are similar to those represented in 
      the included studies.
CI  - (c) The Author(s) 2023. Published by Oxford University Press. All rights reserved. 
      For permissions, please email: journals.permissions@oup.com.
FAU - Shumway, Dean A
AU  - Shumway DA
AUID- ORCID: 0000-0001-7758-8891
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
FAU - Corbin, Kimberly S
AU  - Corbin KS
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
FAU - Farah, Magdoleen H
AU  - Farah MH
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care 
      Delivery, Mayo Clinic, Rochester, MN, USA.
FAU - Viola, Kelly E
AU  - Viola KE
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care 
      Delivery, Mayo Clinic, Rochester, MN, USA.
FAU - Nayfeh, Tarek
AU  - Nayfeh T
AUID- ORCID: 0000-0001-9052-5537
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care 
      Delivery, Mayo Clinic, Rochester, MN, USA.
FAU - Saadi, Samer
AU  - Saadi S
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care 
      Delivery, Mayo Clinic, Rochester, MN, USA.
FAU - Shah, Vishal
AU  - Shah V
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care 
      Delivery, Mayo Clinic, Rochester, MN, USA.
FAU - Hasan, Bashar
AU  - Hasan B
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care 
      Delivery, Mayo Clinic, Rochester, MN, USA.
FAU - Shah, Sahrish
AU  - Shah S
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care 
      Delivery, Mayo Clinic, Rochester, MN, USA.
FAU - Mohammed, Khaled
AU  - Mohammed K
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
FAU - Riaz, Irbaz Bin
AU  - Riaz IB
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
FAU - Prokop, Larry J
AU  - Prokop LJ
AD  - Library Public Services, Mayo Clinic, Rochester, MN, USA.
FAU - Murad, M Hassan
AU  - Murad MH
AUID- ORCID: 0000-0001-5502-5975
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care 
      Delivery, Mayo Clinic, Rochester, MN, USA.
FAU - Wang, Zhen
AU  - Wang Z
AD  - Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA.
AD  - Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care 
      Delivery, Mayo Clinic, Rochester, MN, USA.
AD  - Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Systematic Review
PL  - United States
TA  - J Natl Cancer Inst
JT  - Journal of the National Cancer Institute
JID - 7503089
SB  - IM
MH  - Humans
MH  - Female
MH  - *Breast/pathology
MH  - *Breast Neoplasms/radiotherapy/surgery/pathology
MH  - Mastectomy, Segmental
MH  - Radiotherapy, Adjuvant/adverse effects
PMC - PMC10483267
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2023/06/08 19:14
MHDA- 2023/09/08 06:42
PMCR- 2024/06/08
CRDT- 2023/06/08 12:12
PHST- 2023/05/23 00:00 [accepted]
PHST- 2023/01/30 00:00 [received]
PHST- 2023/05/21 00:00 [revised]
PHST- 2024/06/08 00:00 [pmc-release]
PHST- 2023/09/08 06:42 [medline]
PHST- 2023/06/08 19:14 [pubmed]
PHST- 2023/06/08 12:12 [entrez]
AID - 7192183 [pii]
AID - djad100 [pii]
AID - 10.1093/jnci/djad100 [doi]
PST - ppublish
SO  - J Natl Cancer Inst. 2023 Sep 7;115(9):1011-1019. doi: 10.1093/jnci/djad100.