ABSTRACT
Objective:
To evaluate the effect of prophylactic irradiation of internal mammary
lymph nodes in
patients with
breast cancer in this
Meta-analysis.
Methods:
CNKI, Wanfang Medical network, CBM,
PubMed, EMBASE and Web of
Science were searched by
computer. The controlled clinical studies comparing whether or not internal mammary
lymph node irradiation as an intervention were included and the quality of the included
literature was evaluated according to Newcastle-Ottawa Scale (NOS). RevMan 5.3
software and Stata 14
software were used for
Meta-analysis.
Results:
A total of 11 original articles were included, and 13 181
patients were included for
Meta-analysis. There was no statistically significant difference in the overall
survival (OS) between
patients with and without internal mammary
lymph node irradiation ( P=0.490). The subgroup
analysis using the date of
treatment and the degree of
risk in the enrolled
population as criteria showed that 5-year OS was significantly increased after internal mammary area irradiation in high-
risk stage Ⅱ-Ⅲ
patients (N+ , T 3-T 4 stage) with the date of
treatment of after 2000( P=0.003, 0.006). Compared with
patients without internal mammary area irradiation, internal mammary irradiation significantly increased the 5-year
disease-free survival (DFS)( P<0.001).
Conclusion:
Under the modern
radiotherapy technology, internal mammary
lymph node irradiation improves the DFS of
patients, and may bring OS benefits to high-
risk stage Ⅱ-Ⅲ
breast cancer patients (N+ , T 3-T 4 stage).