Radiotherapy and breast reconstruction: a meta-analysis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : M Barry M. R. Kell
- چاپ و سال / کشور: 2011
Description
The optimum sequencing of breast reconstruction (BR) in patients receiving postmastectomy radiation therapy (PMRT) is controversial.Acomprehensive search of published studies that examined postoperative morbidity following immediate or delayed BR with combined radiotherapy was performed. Medical (MEDLINE & EMBASE) databases were searched and cross-referenced for appropriate studies where morbidity following BR was the primary outcome measured. A total of 1,105 patients were identified from 11 appropriately selected studies. Patients undergoing PMRT and BR are more likely to suffer morbidity compared with patients not receiving PMRT (OR = 4.2; 95% CI, 2.4–7.2 [no PMRT vs. PMRT]). Reconstruction technique was also examined with outcome when PMRT was delivered after BR, and this demonstrated that autologous reconstruction is associated with less morbidity in this setting (OR = 0.21; 95% CI, 0.1–0.4 [autologous vs. implantbased]). Delaying BR until after PMRT had no significant effect on outcome (OR = 0.87; 95% CI, 0.47–1.62 [delayed vs. immediate]). PMRT has a detrimental effect on BR outcome. These results suggest that where immediate reconstruction is undertaken with the necessity of PMRT, an autologous flap results in less morbidity when compared with implant-based reconstruction.
Breast Cancer Res Treat (2011) 127:15–22 Received: 24 August 2010 / Accepted: 7 February 2011 / Published online: 20 February 2011 Springer Science+Business Media, LLC. 2011
